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COEXRIGHT DEPOSIT. 



IX I 



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THE 



PREVENTION AND CURE 

OP 

DISEASE: 

A PRACTICAL TREATISE 

ON THE 

NURSING AND HOME TREATMENT 

OF THE SICK. 



CONTAINING 



Instructions on Prolonging Life. 
Rules for Avoiding Contagious Diseases. 
The Principles of Ventilation and Disinfec- 
tion. 
The Prevention of Decrepitude. 
How to have Healthy Homes. 
How to Prevent Special and Common Diseases. 
How to Nurse Sick Children. 
Directions for Arranging a Sick-room. 



Receipts for the Sick-table. 

How to Distinguish Diseases. 

Useful Facts in Anatomy and Physiology. 

The Medicinal Properties of Common Sub- 
stances. 

American Plants and their Medical Virtues. 

The Domestic Treatment of Diseases. 

Accidents and Injuries, and How to Treat 
them. Etc. etc. etc. 



BY 

GEO. H. NAPHEYS, A.M., M.D., 

One of the Editors of the " Half-Yearly Compendium of Medical Science ;" of the " Physician's Annual : 
late Chief of Medical Clinic of Jefferson Medical College ; Member of the Philadelphia County- 
Medical Society ; Corresponding Member of the Gynaecological Society of ] 
Author of " Modern Therapeutics ;" "The Physical Life of Woman;' 
" Letters from Europe," etc. etc. 









" Without health, life is not life." 



WITH NUMEROUS FULL-PAGE ILLUSTRATIONS. 



SPRINGFIELD: 
W. J. HOLLAND & 

1872. 



CO, 



L_ 







Entered according to the Act of Congress, in the year 1871, by 

GEO. H. NAPHEYS, M.D., 

in the Office of the Librarian of Congress, at Washington. All rights reserved. 



PEEF ACE 



A somewhat extended intercourse with the profession and 
with the general public has led the author of the present 
work to believe that there is a large body of facts in medical 
science which both would gladly see presented in a popular 
form. 

The directions of the physician are frequently not carried 
out through want of intelligence, and he often suffers in his 
own reputation through the ignorance of those he leaves in 
charge of his patients. The public are willing and anxious 
to learn what the physician would be glad to have them 
know, but neither they, nor, it would appear, those medical 
writers who have sought to instruct them, have distinguished 
between what they can and ought to learn, and those dry and 
abstruse parts of science which will probably repel and cer- 
tainly not benefit them. In the present volume the author 
has attempted to avoid this mistake. 

The care of health, the rules for skilful nursing, the pre- 
vention of disease, and its treatment by simple methods, are his 
chief themes. !N"o one, it matters not what his views may be, 

(9) 



10 PREFACE. 

can well hold either that these topics are unimportant, or 
that the public are already sufficiently acquainted with them. 

If some members of the profession think that here and there 
the author has attempted to instruct the non-medical public 
in points on which physicians alone should have an opinion, 
or if some unprofessional readers are disappointed that he has 
not gone more profoundly into the depths and mysteries of 
medical matters, he asks both to remember that in writing 
on popular science for an extended public, special and circum- 
scribed lines of instruction, as well as narrow and limited 
views, must alike be discarded. 

Considerations of a similar nature have led to the omission, 
in the present volume, of all medical topics which may not be 
freely discussed in the family circle. In two previous works 
the author has given to the public what information seemed 
to him proper and useful on the hygiene and diseases peculiar 
to the sexes, and to these volumes those are referred who 
require such instruction. 

Rue db Fleurtts, Paris, 1871. 




CONTENTS. 



PAGE 

Preface 9 

List of Illustrations 29 



INTRODUCTORY. 

THE SCOPE AND PURPOSE OF THE PRESENT WORK. 

The value of popular medicine — The plan of the book — The first part — 
The second part — The third part — What this book is not . . 33 



PAET I. 

THE PRINCIPLES OF HY&ffiNE 

CHAPTER I. 

ON HEALTH AND LONG LIFE. 

How long we ought to live — Instances of longevity — Conditions of life 
and health — Influence of climate ; of race ; of sex ; of hereditary 
tendency ; of marriage and single life ; of trades, professions, and 
social standing — Physical signs of a long life . . . .41 

(11) 



12 CONTENTS. 

CHAPTEE II. 

ON FOOD. 

PAGE 

Section I. Animal Food. Milk — Butter — Eggs — Beef and veal — Mut- 
ton and lamb — Pork — Salted meats — Fat and lean meat — Fowls — 
Game — Fish — Shell-fish — Diseased meats and how to detect them — 
Poisonous flesh — Diseased and poisonous milk — Poisonous honey . 54 

Section II. Vegetable Food. Starch — Sugar — Bread — Vegetables- 
Poisonous confectionery . .74 

Section III. Spices and Condiments. Salt — Black pepper — Red 
pepper — Mustard — Vinegar 80 

Quantity of Food — What we shall eat — Hours of meals— Cookery- 
Adulterations of food — Adulterated bread, arrowroot, butter and 
cheese, sugar, tea, and coffee ... .... 83 



CHAPTEE HI. 

DRINKS AND NARCOTICS. 

Water — Danger from lead pipes — Excessive use of water — How to purify 
water — Tea and coffee — Chocolate . . . . . . .94 

Temperance drinks : Soda-water — Lemonade — Iced tea — Beers , . 103 
Alcoholic beverages, their use and abuse : Distilled liquors — Wines — The 

cure of drunkenness . ' 104 

Narcotics ; Tobacco— Opium — Opium-eating and its cure . . .111 
Hunger and thirst — T'o appease thirst 115 



CHAPTER IV. 

CLOTHING AND THE TOILET. 

Material of clothing : Wool — Silk — Cotton — Linen. The color of cloth- 
ing — Covering of the head — The neck — Underclothing — Boots and 
shoes— Overcoats. The toilet: Care of the teeth— The hair— The 
skin 120 



CONTEXTS. 13 

CHAPTER V. 

ON HEALTHY DWELLING-HOUSES. 

PAGE 

The choice of a building site — Building material — The cellar — The upper 
stories — Drainage and waste products — Light and means of lighting 
— Artificial light — Kerosene and dangerous oils — Effect of artificial 
light on air — The ventilation of dwellings — Means of warming — 
Regulation of temperature — Paper-hangings — Furnishing a house — 
The kitchen and its furnishing — Newly -built houses — Old houses . 135 



CHAPTER VI. 

ON EXERCISE. 

The objects and principles of exercise — "Walking — Riding and driving — 
Precautions in travelling — Various exercises — Light gymnastics — 
Rowing — Swimming — Dancing — Boxing — Quoit-playing — On train- 
ing . ... 167 



CHAPTER VII. 

ON REST AND SLEEP. 

Change of occupation — Recreation — Sleep : amount of sleep ; hours of 
sleep ; how to induce sleep ; to escape bad dreams ; the awakening— 
The bed and bedclothing — Night-clothing — The bedfellow — The 
chamber : ventilation ; warming ; presence of plants ; of odors — Sleep- 
walking and how to cure it 181 



CHAPTER VIII. 

THE PREVENTION OE SPECIAL DISEASES. 

Section I. Hereditaky Diseases. The prevention of consumption 
and scrofula : by physical and mental education ; by occupation ; 
special directions as to food, exercise, bathing, and climate — The 



14 CONTENTS. 

PAGE 

prevention of insanity ; insanity from indigestion ; childbed in- 
sanity ; insane asylums ; examples of insanity — The prevention of 
epilepsy — The prevention of disease of the heart — The prevention 
of gout 200 

Section II. Diseases Incident to Certain Occupations. The 
dangers of mental labor, and means of prevention — Diseases incident 
to indoor occupations — Workers among lead and paint — Workers in 
copper ; in phosphorus ; in iron — Diseases of potters . . . 218 

Section III. Contagious Diseases. How to avoid contagious dis- 
eases in general — Difference between a contagious and an infectious 
disease — How not to catch a disease — The use of disinfectants : car- 
bolic acid ; permanganate of potash ; sulphate of iron ; sulphur ; 
charcoal; quicklime; fresh earth; the earth-closet — General pre- 
cautions to be observed by attendants on the sick .... 226 

Section IY. Special Contagious Diseases. The prevention of scarlet 
fever : by drugs ; by sanitary precautions — The prevention of small- 
pox — Vaccination : how to prepare the patient ; to prepare the vac- 
cine matter ; to apply the virus ; prejudice against vaccination ; 
revaccination — The prevention of typhus fever — The prevention of 
typhoid fever— The prevention of swamp fevers (chills and fever): 
temporary precautions ; specific preventives ; permanent preven- 
tives ; advantage of trees ; advantage of plants ; use of petroleum ; 
use of cider — The prevention of cholera : personal precautions ; 
treatment of the early stage ; specific preventives ; general preven- 
tive measures — The prevention of hydrophobia 235 

Section Y. Diseases not Contagious. The prevention of apoplexy 
and palsy — To prevent indigestion and dyspepsia — To prevent diar- 
rhoea and dysentery — To prevent worms — The prevention of diseases 
of the skin : by cleanliness ; by diet ; by clothing ; by occupations — 
To prevent sea-sickness — To prevent diseases of the eyes : rules for 
preserving the sight ; benefit of a sea-voyage in impaired sight ; 
danger to the eyes of tight boots ; dangers from the use of alcohol 
and tobacco 267 



CONTENTS. 15 

CHAPTER IX. 

THE PREVENTION OF DECREPITUDE. 

PAGE 

The chemical prevention of old age— General rules for the prolongation 
of life — The natural progress of old age — The diet of elderly persons 
— Physical exercise in old age — Preservation of warmth in old age 
— Advantage of travel — Mental exercise in old age — Influence of 
temper and emotion — How to preserve the eyesight in advanced life 
— How to preserve the hearing — At what age to retire from busi- 
ness — The prevention of the diseases of the aged — Rejuvenation in 
old age . 285 



CHAPTER X. 

ON DEATH. 

The fear of death — The love of life — The pain of death — Sudden death — 
The signs of approaching death — The last words — Presentiments of 
death — Buried alive — Deceptive appearances of life : continued 
warmth of the body ; color in the cheeks ; bleeding after death — 
Tests of actual death : the blister test ; the needle test ; the eye test ; 
the eye spot ; decomposition 



CHAPTER XI. 

THE DISPOSAL OF THE DEAD. 

The mortal remains— The care of the corpse— The rigidity of death- 
How long a body should be kept — How to preserve a body : by cold ; 
by the external use of disinfectants; by injection; by drying; by 
embalming — Can contagious diseases be caught from corpses ?— The 
material for coffins — Cemeteries and their locations— Poisonous ex- 
halations from cemeteries — Burning the dead 330 



16 CONTENTS. 



PART II. 

THE NURSIN& OF THE SICK. 

INTRODUCTORY. 

THE IMPORTANCE AND DIVISIONS OF THE SUBJECT. 

PAGE 

Nursing a matter of national concern— The knowledge needed by a 
nurse— The divisions of the subject . . . . , - , 349 

CHAPTER I. 

THE NURSING OF CHILDREN. 

Section I. The Recognition of Diseases in Children. Distinction 
between slight ailments and actual diseases— Signs of disease in 
childhood : Position and movements ; Loss of flesh ; Expression of 
the face ; Dislike of light and noise ; Manner of crying ; Character 
of the cough ; Changes in the pulse ; Nature and seat of pain ; Heat 
of skin; Disturbed sleep; Appearance of the tongue; Manner of 
drinking ; The appetite ; The belly ; Vomiting ; The passages ; Fits 353 

Section II. The Chamber of the Sick Child. Order and cleanli- 
ness, importance of and how to maintain them — Ventilation — Quiet- 
ness — Amount of light— Degree of warmth — Visitors . . .38 

Section III. The Person of the Sick Child. Cleanliness— Bathing : 
How to bathe a sick child ; Cold, warm, hot, and medicated baths — 
The linen— Bed and bedding .... ... 392 

Section IV. The Food and Drinks of the Sick Child. The amount 
of the drinks— The temperature of the drinks— Diet drinks : Barley- 



CONTENTS. 



17 



water; Oatmeal gruel; Rice-water; Toast-water; Sour drinks; Milk; 
Tea • Coffee — Dietetic preparations : Arrowroot pap ; Arrowroot pap 
with milk ; Tapioca ; Sago ; Panada ; Pap of unbolted flour ; Pap of 
boiled flour; Gelatine food; Dr. Merei's food for children; Arrow- 
root and beef-tea ; Prof. Liebig's soup ; Raw meat ; Prof. Trousseau's 
receipt — Attention to giving food — Quantity of food and number of 
meals . 399 

Section Y. The Recovery of the Sick Child. Neglect of the con- 
valescent — Period of confinement to the bed and room — Diet of the 
convalescent — Exercise during convalescence — When to return to 
school 412 



CHAPTER II. 



THE NUKSINa OF ADULTS. 



Section I. The Sick-Room. The structure of the sick-room — The fur- 
niture of the patient's chamber: Bedstead; Thermometer; Feeder; 
Medicine -spoon ; Medicine-glass ; Sick-tray ; Lamp and saucepan ; 
Nursery lamp ; Stomach-warmer ; Foot-warmer ; Air and water 
cushions ; Clothes-cradle ; Bedside-pocket ; Wicker-baskets ; Fun- 
nels ; Porringer ; Oiled silk ; Bandages ; Sponges ; Hand-bell ; Bed- 
chair ; Invalid-lifter ; Invalid-wrap ; The bed and bedding — The 
warming of the sick-room — The ventilation of the sick-room : The 
relation of atmospheric purity to temperature ; An important hint — 
The light of the sick-room — Cleanliness of the sick-room — Twenty- 
four hours in the sick-room — Management in the sick-room — The 
petty cares and needs of the sick-room 420 

Section II. The Person op the Patient. The care of the skin — 
The sponge-bath — Acid sponging — Salt-water sponging — The warm 
bath— The hot bath— The cold bath— Local baths : The foot-bath ; 
Acid foot-bath ; The hip-bath ; The shallow bath — The dripping sheet 
— Cold affusion — The douche-bath — Wet sheet packing — The wet 
compress — The plunge-bath — Medicated baths : Sulphur bath ; Com- 
pound sulphur bath ; Alkaline bath ; Acid baths ; Iodine bath ; 
Borax bath ; Creasote bath ; Hemlock and starch bath ; Artificial 
sea-water baths — The Turkish bath — The shower-bath — The vapor- 
2 



18 CONTENTS. 

PAGE 

bath — The dry heat air-bath — The nurse's hands; How to clean 
them — The clothing of the patient — Exercise and sleep — How to 
secure sleep to the patient — To change the sheets under the sick — To 
change the clothing of the sick — To move the patient in bed — To 
carry the patient . 449 



CHAPTER III. 

COOKERY FOR THE SICK. 

The choice of common articles of food for the sick — Ladder of meat diet 
for invalids — Vegetable food needed by the sick — Jellies — The use 
of tea and coffee by the sick — The diet of health not that of sickness 
—The invalid's hours of meals — The preparation of common articles 
of food for the sick — Modes of cooking for the sick .... 476 

Receipts for the sick-table ; Nutritious beef-tea ; Eggs, cream, and beef- 
tea ; Gruel and beef-tea ; Extract of beef ; Essence of beef; A nour- 
ishing soup ; Restorative soup ; Strong broths for convalescents ; 
Chicken broth ; Lamb broth ; Baked partridge ; Broiled partridge ; 
Broiled tripe; Calves' feet in milk ; Mutton or veal broth ; Chicken 
jelly; Vegetable soup ; Soup tablets; Oyster soup; Broiled oysters ; 
Panned oysters ; Roast oysters ; Stewed oysters ; Scolloped oysters ; 
Frozen oysters ; Suet pudding ; Suet boiled in rice-milk ; Wine 
whey , Lime-water and milk ; English milk porridge ; Spanish 
cream ; Soft custard ; Directions for beating eggs light ; Artificial 
ass's milk ; Artificial goat's milk ; Milk, flour, and iron ; Brandy 
and egg mixture ; Boiled rice ; Macaroni and vermicelli ; Rice pud- 
ding ; Irish moss blanc mange ; Caudle ; Oatmeal mash ; Cornmeal 
gruel ; Tapioca ; Sago ; Tapioca or sago with eggs ; Corn-starch ; 
Bran bread ; Milk bread ; Potato yeast ; Corn bread ; Bread pud- 
ding ; Cracker pudding ; Milk toast ; Apple or other fruit with 
bread-crumbs ; Bread jelly ; Gelatine jelly ; Iceland moss jelly ; 
Irish moss jelly ; Iceland moss and bitter jelly ; Calves' foot jelly ; 
Slippery-elm jelly ; Rice jelly ; Sago jelly ; Toast-water ; Tamarind- 
water ; Barley-water ; Thin barley-water for drinks ; Thick barley- 
water ; Almonds and milk 490 

Nutritious clysters •. Beef-tea and cream injection ; Cod-liver oil and bark 
injection; Quinine and beef-tea injection 514 



CONTENTS. 19 



CHAPTER IV. 

DIRECTIONS FOR THE ADMINISTRATION AND APPLICATION OF 
MEDICINES TO THE SICK. 

PAGE 

The preparation and use of external applications — Poultices : Bread and 
milk poultice ; Simple bread poultice ; Flaxseed-meal poultice ; Car- 
rot poultice ; Slippery-elm poultice ; Arrowroot poultice ; Medicated 
poultices ; Yeast poultice ; Charcoal poultice ; Bran poultice ; Onion 
poultice ; Mustard poultice ; Fig poultice 516 

Cold and warm water-dressings — To make a cold application in the 
absence of ice — Fomentations — Stuping — Steaming — Medicated lo- 
tions ; Sugar of lead and opium solution ; Aconite lotion ; Cooling 
lotions ; Lotions to allay itching of the skin ; Carbolic acid ; Borax 
and glycerine— Solution of arnica—Protective Solutions ; Solution 
of gutta-percha ; Collodion — Liniments 523 

Blisters — How to apply a blister — The time it should remain on — How to 
dress it — How to blister quickly — The application of leeches — How 
to make the leech take hold — How to handle leeches — To make the 
leeches work — The number of leeches to be applied — How to leech 
near the eye or mouth — Parts not to be leeched — The removal of the 
leeches — To promote the bleeding — To stop the bleeding — The 
amount of blood drawn — How to take care of leeches — Directions 
for cupping — Directions for the administration of injections — Receipts 
for injections 529 

The doses of the more common medicines— How to ascertain the dose for 
a child — Doses for adults— How to measure medicines — How a pre- 
scription is written — The time of the day to administer medicines — 
The intervals between each dose — Constitutional peculiarities in 
regard to the effects of medicines— Superstitious notions . . . 548 



CHAPTER V, 

ACCIDENTS IN THE SICK-ROOM. 

Fainting ; How to ward off impending fainting — Shivering — Vomiting— 
Convulsions or fits— Delirium— Words uttered during deliiium . 564 



20 CONTENTS. 

CHAPTER VI. 

NOTES AND MAXIMS ON NURSING. 

PAGE 

Duties of the nurse — Nightgowns for the sick — Visitors to the sick-room 
— Rules for nursing — The requirements of the sick-room — Time 
necessary for cure — Sudden death in children — Causes of "no appe- 
tite" — Pure air — Amusement for the sick — Children in the sick-room 
— Avoid alarming the sick — The feet of the sick — Care of the head — 
Breathing air — The causes of unclean air — Neatness of dress — 
Respect for human life — Caution in regard to the food of the sick- 
Poultry for the sick — Sitting up all night — Deportment about the 
dying — Mistaken zeal — A word of caution as to contagion — Whisper- 
ing in the sick-room — How to drop medicine into the eye — Aid in 
getting in and out of bed — Influence of the mind over the sense of 
pain — Duty of amusing sick children — Why must children have 
children's diseases? — How to make a short dressing-gown — Impor- 
tance of good nursing , 572 



CHAPTER Vn. 

CARE OF THE INFIRM. 

The care of the aged — The care of the insane : at home ; in asylum — The 
care of the idiot — Educational institutions for the feeble-minded — The 
care of the inebriate .... . . . . . .593 



CONTENTS. 21 



PART III. 

DISEASES AND THEIR CURE. 

CHAPTER L 

THE FORM AND FUNCTIONS OF THE HUMAN BODY. 

PAGE 

The external form of man — The bones — The flesh or muscles — The 
organs or viscera — The contents of the abdomen — The contents of 
the chest — The contents of the skull — The special senses — External 
location of parts — The proportions of the human figure — The height 
of the body — Weight of the body — Relations of height and weight in 
health — Table of the expectation of life . . ' . . . . 603 

CHAPTER II. 

DISEASES AND HOW TO DISTINGUISH THEM. 

Incurable diseases — Diseases that cannot be recognized — How to distin- 
guish diseases — How to examine an invalid — The pulse — The tongue 
— The mind and special senses — The organs of breathing — The heart 
— Organs of digestion — The appetite — Vomiting — Thirst — Action of 
the bowels — The kidneys and bladder — The skin — Behavior in the 
sick-room 618 

The geographical distribution of diseases : In New England ; The Atlantic 
States ; The Central States ; The Pacific States 638 



22 CONTENTS. 

CHAPTER III. 

HYGIENIC MEANS OF CUKE. 

PAGE 

Ancient methods of cure — The natural means of cure — Mineral springs — 
Iron or chalybeate springs — Sulphur springs — Alkaline and carbo- 
nated waters — Salt springs — Miscellaneous springs — Advice to those 
using mineral-waters , . 642 

Change of climate — What kind of a climate to choose — The climates of 
the United States — The most healthful warm climate — General direc- 
tions in changing climates 654 

The Swedish movement cure — Movements for cold hands and feet ; for 
constipation ; dyspepsia — The lifting cure — Electricity : how to apply 
it ; diseases benefited by it ; loss of voice ; special senses ; palsy ; 
rheumatism ; poisoning, etc . 663 



. CHAPTER IV. 

ON MEDICINES. 

What are medicines ? — Sources from which medicines are derived — How 
medicines act — The various ways in which medicines are given — 
The forms in which medicines are dispensed — Medical weights and 
measures — What " domestic medicines" properly are . . . 680 

Section I. The Medical Properties of Common Articles. Alco- 
hol and alcoholic liquors — Alum — Borax — Coal oil — Charcoal — Com- 
mon salt — Cream of tartar — Ginger — Lemon-juice — Lime — Mustard 
— Olive oil — Red pepper — Saltpetre, or nitre — Soda — Sulphur — Tar 
— Turpentine — Vinegar — Water . . . . . . 694 

Section II. The Medical Properties op Domestic Plants. When 
and how to gather medicinal plants . . . . . . . 723 

1st. Trees and Shrubs. American poplar — Bear-berry — Black elder — 
Blackberry — Burdock — Cleavers, or goose-grass — Dogwood — Juni- 
per — Oak-bark — Persimmon — Poke-weed — Sassafras — White walnut 
—Wild cherry— Willow 726 

2d. Serbs and Plants. Calamus— Dandelion— Flaxseed— Fleabane— 
Garlic— Hops— Horseradish— Lettuce— Lobelia— Parsley— Pepper- 
mint— May-apple— Sage— Seneca snakeroot— Thorn-apple— Tansy- 
Virginia snakeroot— Wormseed 735 



CONTENTS. 23 

PAGB 

Section III. The more Important Chemical and Foreign Drugs. 

1st. Vegetable Drugs. Aloes — Assafcetida — Belladonna — Camphor — Cas- 
tor oil — Cinnamon — Foxglove — Jalap — Ipecac — Opium — Peruvian 
bark and quinine — Rhubarb — Senna 747 

2d. Mineral and Chemical Drugs. Bromide of potassium — Calomel — 
Carbolic acid— Chloral— Chlorate of potash — Iron— Magnesia — Sugar 
of lead — Epsom salts 759 



CHAPTER V. 

STANDARD DOMESTIC REMEDIES. 

The importance of reliable family medicines — The dangers and uncer- 
tainties of secret and patent medicines— How the legitimate demand 
for carefully selected domestic remedies may be met — The principles 
which should govern their selection; Efficacy of the preparation; 
Absence of dangerous properties ; Avoidance of unpleasant taste ; A 
convenient, compact, and portable form — The family anodyne 
recommended — The astringentr— The purgative — The emetic — The 
expectorant — The stimulant — The tonic — The febrifuge — The diu- 
retic — The antiperiodic — The vermifuge — The salve — The ointment 
for itch— The alterative ' . .767 



CHAPTER VL 

ON GENERAL DISEASES. 

The causes of disease — Communicable, infectious, endemic, and heredi- 
tary affections — Diseases from unknown causes 784 

Scrofula. Definition of the disease — Its extent and mortality — The 
causes of scrofula — Is it contagious? — Is it dangerous ? — How long it 
lasts — The consequences it leaves — How to recognize it — How to 
treat it : Hygienic means of cure ; medicinal means of cure, by home 
remedies, by drugs and standard remedies 786 

Scurvy. Its prevalence in former times — The circumstances under 
which it appears — Influence of age and sex ; of previous health ; of 
weather and climate ; of diet — Is it dangerous ? — Its duration — How 
to tell it — The treatment : by diet, by medicines . . . 798 



24 CONTENTS. 

PAGE 

Eheumatism. The two forms of the disease — Rheumatic fever — Cir- 
cumstances under which it appears — Influence of age, of sex, of 
previous health, of the season of the year, weather and climate, of 
occupation — Is it dangerous ? — How long it ordinarily lasts — How to 
tell it — The treatment: by nursing, care of the affected joints, by 
medicines — Chronic or muscular rheumatism — Causes of the disease 
— Influence of age — Lumbago — Wryneck — Treatment of muscular 
rheumatism. . 808 

Smallpox. Protection afforded by one attack — Inoculation as a preven- 
tive — Vaccination — History of its discovery — Circumstances which 
favor the appearance of smallpox — Influence of age, fear, race, con- 
tagion — The period of the disease when there is the most danger 
from contagion — The mortality of smallpox — Its after-effects — How 
to recognize the disease — The symptoms — The treatment — Diet of 
the patient — The care of the person of the patient — How to relieve 
the itching— How to prevent pitting — The modern treatment — Regu- 
lations proper during an epidemic of smallpox — Varioloid . . 822 

Milk-Sickness. Its nature — When prevalent— Discovery of the cause 
of the disease — Treatment . . 850 



CHAPTER VII. 

DISEASES OF THE ORGANS OP BREATHING. 

Cold in the Head. Causes — Is it ever contagious ? — Duration of the 
attack — The symptoms of the disease — The treatment — The dry plan 
of cure — Treatment by the standard domestic remedies . . . 857 

Rose Cold, or Hat Asthma. The causes which produce it — The 
symptoms which characterize it — The treatment which benefits it 865 

Cold on the Breast, or Bronchitis. Causes, duration, and mor- 
tality of the disease — How to recognize it — The treatment proper 
for children, adults, and old persons 869 

Chronic Catarrh of the Chest. Circumstances which favor its 
appearance — The symptoms — The treatment 875 

Pleurisy. Nature of the affection— How caused— Its symptoms— Its 
treatment 879 



CONTENTS. 25 

PAGE 

Inflammation of the Lungs, ob Pneumonia. Circumstances under 
■which it appears — Its duration — How to recognize it — How to treat 
it : by home remedies, by drugs, and the standard domestic remedies 
— Treatment of inflammation of the lungs in children . . . 882 

Asthma. The causes and influences which predispose to the disease — 
The effects of the disease — The duration of an attack — The symp- 
toms — The treatment : by common articles, by diet, by domestic 
plants, by drugs, and the standard domestic remedies . . . 890 

Consumption of the Lungs. The wide-spread dread of this disease — 
Definition ©f the affection — The circumstances under which it ap- 
pears — Influence of age — Influence of sex — Influence of inheritance 
— Influence of climate — Influence of occupation — Influence of diet — 
Is consumption contagious ? — Its mortality rates — The duration of the 
disease — The symptoms — Means of prevention — The curability of 
consumption — The treatment — Diet — Scheme of daily diet — Special 
articles of food — Exercise in the open air — Care of the skin — The 
clothing — Change of climate — The medicinal treatment of consump- 
tion — Cod-liver oil — Iodine — Arsenic — Counter-irritation — How to 
relieve the cough — How to check the night-sweats — How to stop the 
bleeding from the lungs — The treatment of the diarrhoea — Use of 
domestic plants in the disease — Treatment by the standard domestic 
remedies 904 



CHAPTER VIH. 

DISEASES OP THE HEART. 

Enlargement of the Heart. Causes of enlarged heart— The symp- 
toms — The treatment by diet, by rest, by medicines .... 935 

The Blue Disease. Its nature— The symptoms— The mortality of the 
disease — The treatment 940 



26 CONTENTS, 

CHAPTER IX. 

DISEASES OF THE ORGANS OF DIGESTION. 

PAGB 

Cholera. Its fatal character — Definition of the disease — Where and 
how it originates — The manner in which it travels from country to 
country — Circumstances which predispose an individual to an attack 
— Is it contagious ? — How to prevent it — The symptoms of cholera — 
The treatment . . . . .945 

Dyspepsia. The causes— Avoidable causes : eating too much ; eating 
too little ; sedentary habits ; solitude ; improper use of purgative 
drugs ; tight-lacing ; the abuses of alcohol, tea, tobacco, and opium — 
Unavoidable causes — The symptoms of dyspepsia — The treatment: 
by diet; by medicine, home remedies, and drugs — Heartburn, its 
causes and treatment — Sour stomach, causes and treatment — Flatu- 
lency, causes and treatment— Pains in the stomach — Value of min- 
eral springs for dyspeptics , 954 

Constipation op the Bowels. The causes of constipated bowels: 
the abuse of purgative medicines ; indolent habits ; neglect of nature's 
calls ; errors in diet ; old age — The treatment : by hygienic means, 
movements, diet, use of water, exercise, mineral springs, and home 
remedies 973 

Diarrhoea or Looseness. Definition — The cause of diarrhoea — Its 
mortality — How to treat it — Chronic diarrhoea and its treatment . 985 

Dysentery, or Bloody Flux. Difference between diarrhoea and dys- 
entery — The fatal character of dysentery when epidemic — The causes 
— The symptoms — The treatment 988 

Liver Complaints. The obscure and difficult character of diseases of 
the liver — Jaundice — The meaning of the name — The symptoms of 
jaundice— The causes — The treatment . . . . ■ 994 



CHAPTER X. 

DISEASES OF THE NERVES. 

Neuralgia. Definition — Circumstances under which neuralgia appears 
— Influence of age, previous health, season of the year, climate — Is 



CONTENTS. 27 

PAGE 

it dangerous? — The duration of neuralgia — The causes — The symp- 
toms — Yarieties of neuralgia — Neuralgia "of the face — Brow-ague — 
Sciatica — Neuralgia of the side — The treatment : by diet, by medi- 
cines. Epilepsy : Definition of the disease — Circumstances under 
which it appears — Influence of age, sex, previous health, diet, in- 
heritance — The causes — The duration — The symptoms — The treat- 
ment. Catalepsy : Nature of the affection — Its causes and remedies. 
Apoplexy : Causes, symptoms, and treatment. Palsy : The influ- 
ences which induce it — The probabilities as to recovery — How to 
treat it. St. Vitus' Dance : Definition — Origin — Symptoms — Treat- 
ment 1032 



CHAPTER XL 

ON FEVEKS. 

Fever and Ague : Causes of the disease — Symptoms — Different varie- 
ties of— Treatment ; Specific treatment. Typhoid Fever : Nature of 
— Circumstances under which it appears — Is it contagious ? — Causes 
— Symptoms — Treatment. Typhus Fever: Nature of— Circum- 
stances under wlnph it appears — Is it contagious ? — Causes — Symp- 
toms — Treatment. Yellow Fever: How it arises — Where it is 
prevalent — Causes of— Is it contagious? — Symptoms — Treatment . 1043 

CHAPTER XII. 

DISEASES OP CHILDKEN. 

Measles — Scarlet fever — Chicken-pox — Mumps — Whooping-cough — 
True croup — False or spasmodic croup — Diphtheria — Thrush — 
Summer complaint, or cholera infantum — Wasting disease — Kickets 
— Worms — Bed wetting 1047 



CHAPTER XIII. 

DISEASES OF THE SKIN AND KIDNEYS. 

How divided. I. Discolorations of the skin — Sunburn — Tan — Freckles 
— Liver spots. II. Diseases marked by pimples or wheals — Red gum 
or tooth-rash — Nettle rash — Hives and prickly heat — Camp itch, 



28 CONTENTS. 

PAGE 

soldier's itch, or ground itch. III. Diseases with a watery dis- 
charge — Moist tetter, milk crust, scald head, or barber's tetter — 
Fever blisters — Poison yine eruption. IV. Diseases characterized 
by matter or pus — Rosy drop or face pimples. Y. Diseases marked 
by dry scales — Dry tetter — Leprosy. VI. Diseases of mixed char- 
acters — Itch — Ringworm — Barber's itch. VII. Diseases of the kid- 
neys and bladder — Diabetes — Bright' s disease — Gravel — Inflamma- 
tion of the bladder . . 1069 



CHAPTER XIV. 

SURGICAL DISEASES. 

Erysipelas, causes, symptoms, and treatment — Boils — Styes — Carbuncles 
— Felons — In-growing toenails — Corns — Bunions — Warts — Tumors 
— The difference between malignant and non-malignant tumors — 
How to tell a cancer — Piles — Inflammation of the eyes — Toothache 
—Earache 1093 



CHAPTER XV. • 

ACCIDENTS AND INJURIES. 

Sunstroke : its causes, treatment, and prevention — Injuries from cold : 
frost-bites ; chilblains. Treatment of the apparently drowned : first 
measures for restoration ; to restore the breathing ; after breathing 
has been restored ; appearances accompanying death ; cautions — 
Poisons and their antidotes : prussic acid ; laurel-water ; muriatic 
acid; nitric acid; sulphuric acid; oxalic acid; ammonia; mussels; 
crabs and crawfish ; bites of serpents ; rattlesnakes ; copperheads ; 
vipers ; tartar emetic ; arsenic ; belladonna ; thorn-apple ; tobacco ; 
aconite ; copper ; poisonous gases ; lead ; corrosive sublimate ; mush- 
rooms ; nux vomica ; strychnia ; laudanum ; henbane ; savine ; nitrate 
of silver ; tin ; sulphate of zinc — Burns and scalds — Railroad and 
other injuries, and how to stop bleeding — Bleeding of the nose, at 
the lungs — Foreign bodies in the ear, the eye, the nose, the throat — 
Bruises — Sprains — Fainting 1110 



mmmm 








LIST OF ILLUSTEATIONS. 






PAGE 


The model sick-room . . ... . . Frontispiece. 


The earth-closet 


233 


The country churchyard and city cemetery . 


341 


Furniture for the sick-room * 


42? 


Air and water cushions ....... 


432 


The invalid's lifter 


432 


Apparatus for the vapor-bath 


466 


The external location of the organs .... 


612 


Medical chart of America 


638 


The movement cure 


663 


The lifting cure 


663 


(29) 





30 LIST OF ILLUSTKATIONS. 

PAGE 

The castor oil plant 126 

The elder plant . 726 

Belladonna 744 

The thorn-apple . 744 

Mustard 744 

Fleabane 744 

Foxglove 738 

Hops . , . . . 738 

Aloes 748 

The cinnamon plant . . . . . . . 752 

The pepper plant 752 

Garlic 756 

Peruvian bark, or cinchona .756 

American poplar 724 

Blackberry 724 

DogWood . . . 724 

Poke . 728 

May-apple 728 

Wormseed . 728 

Calamus 730 



LIST OF ILLUSTRATIONS. 



31 



PAGE 

Lobelia 130 

Seneca snakeroot 730 

Virginia snakeroot 130 

Treatment of drowning 1061 

Treatment op bleeding 1086 




INTRODUCTORY. 



THE SCOPE AND PURPOSE OF THE PRESENT WORK. 

The value of popular medicine — The plan of the book — The first part — The 
second part — The third part — What this book is not. 




HERE is a hard old maxim, which, hard as it 
is, both history and science confirm, to the 
effect that " to be weak is to be miserable." Look- 
ing at the great problem of achieving success in life, 
which interests us all so much, we see how true this 
is. The weak are pushed to the wall, and especially 
those who are weak through prolonged ill-health. 
They cannot cope with their competitors blessed with 
strong nerves and constitutions of iron. They lose 
too much time, their attention is distracted by their 
own ailments, they cannot work enough, and -they en- 
counter sooner the inevitable and final rival who is 
certain at last to overturn all human plans — Death. 

These three foes to success — Weakness, Sickness, 
Death — the science of medicine takes upon itself to 
encounter. It teaches the means of exchanging de- 
bility for strength, of avoiding, caring for, and curing 
3 ( 33 ) 



34 INTRODUCTORY. 

diseases, and of postponing to the utmost day the un- 
avoidable termination of our career. These are, in- 
deed, lofty and beneficent aims. But it does not stop 
even here. Looking to the future as well as the pre- 
sent, it seeks to erase from the experience of mankind 
all preventable diseases ; to protect the generations yet 
unborn from those ills which we, their sires, must en- 
dure ; to impart a physical vigor and a mental consti- 
tution which will elevate the race above the liability 
to disease, and rescue it from the temptations to dis- 
obey the laws of life ; and thus, joining hands with the 
mighty powers of religion and morality, to render man 
better and purer, as well as stronger and longer-lived. 

THE VALUE OF POPULAR MEDICINE. 

With these aims in view, at once so noble and so 
practical, of such interest to the individual as well as 
the race, it seems strange that medical science in its 
broad sense is not a more favorite study with the in- 
telligent public. Certainly in this day of popularizing 
science, there is no science so deserving of popularity 
as this. 

Perhaps the reason is that the people at large 
imagine that the chief concern of medicine is the 
treatment of disease, a matter not easily understood 
nor pleasant to dwell upon ; perhaps there has been no 
work yet written which is suited to give other and 
more correct views. Domestic medicine books, such 
as they are, we have in abundance, but what are they? 
Dry compilations from the text-books of medical 



SCOPE AND PURPOSE OF THE PRESENT WORK. do 

students, crammed with useless statements, disfigured 
with technical terms, written hastily by superficial 
men on illogical plans, or on no plan at all. No one 
has read them, no one can read them. 

Now, there are in medical science a large number 
of useful facts, applicable to every day of our lives, 
which every man and woman ought to know, igno- 
rance of which will bring anxiety and suffering to 
themselves, and prevent them from doing their duty 
to their friends and relatives. They cannot fulfil their 
obligations as Christians and neighbors without this 
knowledge. Unless the Good Samaritan had known 
enough to wash the bleeding wounds with the astrin- 
gent wine of Palestine, to check the flow of blood, and 
then to apply rags moistened with olive oil — very good 
treatment, by the by, and not far from what we do to- 
day — his services might have been of no avail, and 
the poor traveller might have perished by the wayside, 
in spite of the kindest sympathy on the part of his 
unknown friend. The tenderest affection, the most de- 
voted love, the most unreserved self-sacrifice, amount 
to nothing in sickness, are in nine cases out of ten 
misplaced and harmful, without this knowledge. 

These essential, useful facts it is the purpose of this 
work to give, presenting them in some natural connec- 
tion, and in plain terms. They require no preliminary 
study of anatomy, physiology, or pharmacy; they 
shall be of such character as are needed in e very-day 
life ; and they shall be carefully chosen with regard to 
their accuracy. This much we promise; and if we 
could clothe these facts in the graceful drapery of an 



36 INTRODUCTORY. 

attractive style, and invite to their perusal even the 
indifferent by the charms of language, we would gladly 
call to our aid this potent ally. But to this we lay no 
claim, and here, as in our volumes on a related subject, 
we shall aim at nothing but to impart useful informa- 
tion in perspicuous words. 



PLAN OF THE BOOK. 

The plan which we shall adopt is that which has 
appeared to us the most effective to allow our state- 
ments to be easily remembered. "We shall present it 
in outline here, and it is well to bear it in mind in 
reading the following pages. 

Some may deem it a severe and cold maxim to say 
that every man's first and most imperative duty is to 
himself; others will suggest that there is no need of 
giving such advice, for poor human nature acts only too 
willingly in accord with it already. Both objectors are 
in error. Even in the moral world, the great dramatist 
places in the front rank of paternal admonitions: 
"first, to thine ownself be true;" and the physician 
has to see and regret only too often how an ignorance 
or a neglect of the duties men owe themselves, such 
as the constant exercise of self-control in passions and 
appetites, the observance of the regimen of health, and 
the avoidance of exposure, leads to the saddest results 
for themselves and their families. 



SCOPE AND PURPOSE OF THE PRESENT WORK. 37 



THE FIRST PART. 

Therefore, in the First Part of this work we shall 
speak of the hygienic rules which should govern the 
individual when in health, and impart to him the in- 
valuable information how to escape contagious dis- 
eases, and those which are inseparable from some 
occupations and inherent in some constitutions. In 
other words, it will be a treatise on the principles of 
hygiene. We have not the space to enter into the 
details of this important science, but we shall explain 
the general laws which must be observed in order to 
secure health and make our chances the best for long 
life. This portion, in other words, teaches what a 
person must do for himself. 

THE SECOND PART. 

In the Second Part will be taken up the care of 
those who are already ill. We shall there explain the 
proper way to nurse them, to prepare their food, to 
minister to their many wants, and to provide for them 
whatever comforts the pain-racked couch of sickness 
can command. Every physician well knows that 
instruction on these points is sadly needed; that 
thousands die every year, not from lack of nursing, 
but from officious and ill-advised nursing, through the 
unintelligent though well-meant attentions of their 
families — nursed to death, in fact. The skilful, quiet, 
well-trained nurse is the physician's ablest assistant; 
but such assistants are rare indeed. 



38 



INTRODUCTORY. 



Yet so important is it to know how to care for the 
sick, that there is no man and no woman but in some 
period of life he or she is called upon to do it. And 
upon its being well done depend very often the lives 
most near and dear to them — their parents, their chil- 
dren, their best friends. For it is precisely these who 
demand from us this painful duty. Who, then, can 
be so careless of these dearest ties, who so forgetful 
of this inevitable emergency, as to make no prepara- 
tions for it, to seek no instructions about it? As- 
suredly, if there are such, the day will come when, in 
weeds of mourning, they will bitterly reproach them- 
selves for the culpable oversight. 

THE THIRD PART. 



The Third Part of our work shall be engaged with 
the means of curing disease. There will be general 
directions how to distinguish the complaints most 
frequent in this country, but we shall altogether omit 
the hundreds of rare and obscure diseases which make 
up the bulk of medical works, and can neither be re- 
cognized nor treated by any but the skilled practi- 
tioner. Sudden accidents and the proper help in the 
emergencies of life shall receive especial attention. 

The remedies to be employed shall occupy us very 
particularly, for these are the very "tools of the trade," 
and upon their right management more depends than 
on aught else. We shall lay especial stress on the 
medicinal properties — and they are many— -of such 



SCOPE AND PURPOSE OF THE PRESENT WORK. 39 

articles as are always at hand in every house for other 
purposes, such as salt, mustard, and the like. 

The art of the apothecary is a difficult and a danger- 
ous one. He traffics in subtle poisons, and deals out 
uncertain and unfamiliar substances. No one unini- 
tiated into the mysteries of his craft, dare with impu- 
nity meddle with the vials on his shelves. It were the 
height of imprudence to recommend it. Yet these 
vials contain some of the most potent weapons against 
disease that the arsenal of science can furnish. 

To obviate the dilemma, we shall follow out a sug- 
gestion not indeed original with us, but hitherto not 
carried out in practice, and which, we think, overcomes 
the difficulty in a very great measure. What it is we 
shall explain in the proper place. 

By this plan for our book, we believe we can present 
in a small compass most of what is really worth know- 
ing about practical medicine for the public. "We will 
thus teach the reader, first, how to take care of him- 
self; secondly, how to take care of others, his parents, 
his children, or his friends; and, lastly, inform him 
how to recognize common diseases, and enlighten him 
as to the many resources which are at his hand in 
sudden emergencies, and when no physician can be 
summoned. 



WHAT THIS BOOK IS NOT. 

"We shall now add what he need not expect from 
this book. It will not make him a physician, still less 
will it make "every man his own doctor." The art 



40 INTRODUCTORY. 

and science of medicine requires for its mastery years 
of patient, assiduous, unwearying toil ; years spent by 
the bedside, over the dying, among the dead ; it de- 
mands a much more than superficial familiarity with 
many other sciences, with chemistry, physiology, phar- 
macy, anatomy, and botany. It requires a prolonged 
education of the senses of sight, hearing, and touch. 
It asks a practised adroitness in the management of 
delicate and complicated instruments. It presupposes 
wide general education, and an acquaintance with 
more than one language, living and dead. "When all 
this is given, it is not all. Other long years of obser- 
vation and experience must pass before the healer is 
qualified for his high mission. 

How absurd, how unprincipled, therefore, the author 
who in the compass of one volume professes to in- 
clude all that is requisite for a mastery of this science! 
Such is not the scope or purpose of this work. More 
humble in aim, we hope it will prove more really ac- 
ceptable and profitable to the reader. 




PAET I. 



THE PRINCIPLES OF HYGIENE. 




CHAPTER I. 

ON HEALTH AND LONG LIFE. 

How long we ought to live — Instances of longevity — Conditions of life and 
health — Influence of climate ; of race ; of sex ; of hereditary tendency ; of 
marriage and single life ; of trades, professions, and social standing — Phy- 
sical signs of a long life. 

HERE are two motives which should impel us 
to seek an acquaintance with the laws that 
govern our physical life : the first is, that by respect- 
ing these laws we may preserve our health; the second, 
that we may prolong our life. At the first glance, 
some may think that these are almost identical. In 
many cases they are ; but in many others the precepts 
which we must obey in order to prolong life are in ad- 
dition to those which are requisite to avoid sickness. 

It is not too much to say that health is at the com- 
mand of most people — so much and so entirely in their 
power, that if they are sick, it is their fault, not their 
misfortune. But with life it is different. A thousand 
accidents may await us; a hundred mischances may 

(41) 



42 



ON HEALTH AND LONG LIFE. 



occur to sever the slender thread by which we cling to 
existence. Against all these we cannot provide, but 
we can diminish the natural causes of mortality, lessen 
the risks of accident, and in a double sense live well 
while we live. 

Our purpose is to collect into small compass, and to 
present as perspicuously as possible, all the advice 
which seems most essential to obtaining these desira- 
ble ends. We commence with the inquiry — 

HOW LONG OUGHT WE TO LIVE ? 



Or, to put the question differently, "What is the na- 
tural length of human life ? Let us suppose that man 
were placed in such a position that neither accident 
nor exposure cut short his days, but permitted his cor- 
poreal machine to wear itself out, as some well-worn 
engine, by dint of long use: How long would that be? 

We can arrive at an answer in several ways. Sim- 
plest of all is, to make note of the ages of old people 
who have died of the only disease which we should, 
or should desire, to die of — old age. This we shall 
find to vary somewhat according to race and place ; 
but, on an average, to be upwards of fourscore years, 
perhaps from eighty to one hundred years. 

We can also make this calculation in the lower ani- 
mals; when protected from fatalities, death by decrepi- 
tude takes place at a period from four to five times 
as great as elapses from birth to the attainment of 
growth. For example, a horse attains its full growth 
in about five years ; its natural term of life is a little 



HOW TO LIVE LO^G. 43 

over twenty years. This law is true of most of the 
brute creation. If it also holds good when applied 
to man, then, were it not for accidents, "medicable 
wounds/' and our own folly and ignorance, we should 
all live to the age of a hundred years. 

It will be seen that the results of these two methods 
of calculation are not far apart ; so we can safely 
assume, that any man with a naturally good constitu- 
tion, can, if he wishes, barring accidents, reach an 
age over eighty. "We may even go further than this. 
Instances are not rare, where persons with enfeebled 
health, arising either from a weak constitution or 
from exposure and excesses, have, by a resolute ob- 
servance of the precepts of hygiene, attained an un- 
common age. This gives us the cheerful assurance 
that it is in the power of every one to "go and do 
likewise !" 

But it is not enough simply to live — to exist. 

"What is a man, 
If the chief good and market of his time 
Be but to sleep and feed ? a beast, no more." 

"We must be capable of work, and at work ; and to 
be thus, demands health, vigorous, uniform health. 
That by making the mere act of living the sole care 
of life, we may attain longevity, is a small satisfac- 
tion. "While living, we must, in military phrase, be 
"fit for duty." 



44 ON HEALTH AND LOW LIFE. 

INSTANCES OF LONGEVITY. 

"We give a few of the most remarkable instances of 
longevity on record. 

Probably the man who attained the greatest age 
since the days of the patriarchs, of whom we have any 
authentic account, was Henry Jenkins, of Yorkshire, 
England. He died in 1670, at the age of 169 years. 
He remembered the battle of Floddenfield, in 1513. 
At that time he was twelve years old, and was engaged 
to pick up the arrows shot by the archers. The records 
of the courts proved that, 140 years before his death, 
he was a witness on a trial, and had an oath adminis- 
tered to him. He passed his life in out-door employ- 
ments, in moderate labor and fishing. So well did he 
retain his vigor, that when above the age of a hundred 
years, he could swim across rapid rivers. His epitaph 
is still seen in Bolton church, Yorkshire. 

Thomas Parr, another Englishman, is a still more 
famous example, though his life was shorter. He lived 
to be 152 years and nine months old, and died in 1635. 
He also was a farm-laborer, accustomed to out-door 
work and plain fare. He continued his daily labor, 
even threshing and reaping, until past 130 years of age. 
He would probably have lived many years longer, had 
not the king, hearing the fame of his great age, had 
him brought to London, where he was fed on such un- 
usually dainty fare, that he died of a surfeit. The 
famous physician, Dr. Harvey, examined his body after 
death, and found no other cause of death in it. 

In citing instances of longevity, we cannot omit to 



THE OLDEST AMERICAN. 45 

mention Lnigi Cornaro, a nobleman of Venice, who 
died at the age of 100 years, in 1566. What is most 
interesting in his case is that he was born with a feeble 
constitution, which he further debilitated by a some- 
what dissipated and irregular life, until he was thirty- 
five. His physicians then informed him that he had 
but a year or two to live. Alarmed at this, he changed 
completely his habits, and became the most temperate 
and regular of men. His plan was literally " to be 
temperate in all things." He scrupulously confined 
himself to twelve ounces of food a day, and fourteen 
ounces of wine ; he avoided exposure to great heat or 
cold ; he shunned all strong emotions, and cultivated 
cheerfulness ; he retired early, and rose betimes ; and 
he interested himself in light and genial occupations. 
Undoubtedly his great age was attained directly by 
these precautions. 

In the present century, the most extraordinary, well- 
attested case of longevity is to be found in our own 
country. This was Joseph Crele, who died January 
27, 1866, in Caledonia, Wisconsin. He was born of 
French parents, in what is now Detroit, in the year 
1725, as the record of his baptism in the Catholic 
church in that city establishes beyond a doubt. He 
lived, therefore, to the age of one hundred and forty- 
one years. He was of medium height, spare in flesh, 
and of sinewy strength. Until within two years of 
his death, he could walk several miles without fatigue, 
and chopped all the wood needed for the family use. 
His life had been passed in the open air, in hunting, 
fishing, and trapping. He was temperate, except that 



46 OK HEALTH AND LONG LIFE. 

he was an inveterate smoker. Like many others who 
have attained great age, he married a young woman, 
when far advanced in life, and had a daughter when 
he was sixty-nine years of age. The only weakness 
of mind he ever betrayed was in the last year or two 
of his life, when he occasionally remarked, with an air 
of sadness, " Death has forgotten me." But he would 
soon brighten up, and add, " But God has not." 

CONDITIONS OF LIFE AND HEALTH. 

Now, our chances for life and health depend upon 
two separate factors, each of which we propose to 
examine. First, there are certain conditions of our 
life which are wholly or largely beyond our control, 
and are peculiar to ourselves individually. Such are 
the race to which we belong, hereditary tendency to 
certain diseases, our sex, avocation, married or single 
state, the climate we are exposed to, and the period of 
our lives. Each of these has its own dangers, its own 
advantages, and its own special hygienic rules. 

Secondly, there are other conditions which are com- 
mon to all human beings, and materially influence both 
health and length of days. These are the foods we 
eat, the beverages we drink, the clothes we wear, the 
houses we live in, the exercise we take, and the sleep 
we indulge in. There is much important matter 
which we have to bring forward on each of these 
points also. 



LONGEVITY OF RACES. 47 

CONCERNING- CLIMATE. 

It is well ascertained that the colder parts of the 
north temperate zone are the most favorable to lon- 
gevity. In Europe, Russia, Sweden, Denmark, and 
Scotland, in this country, New England and the 
Northwest, can produce the most numerous examples 
of long life. The extreme cold of the frigid zones, 
and the sultry heats of the tropics, are alike unfriendly 
to great age. The country is more favorable than the 
city, a dry and well-aired locality than one marshy or 
confined, the hill-tops and plateaux than the valleys and 
low plains. 

INFLUENCE OF RACE. 

The influence of race is equally evident. There is 
no doubt that the white or Caucasian race surpasses 
all others in longevity. Few instances of either In- 
dians or Negroes who have reached a very advanced 
age can be found. There is, we well know, a popular 
belief to the contrary, because comparatively few of 
these races know their own age, and often give them- 
selves out as very much older than they really are. 
Probably of all the races, the Jblack is that which is 
the shortest-lived. The mulatto, a cross between it 
and the white race, is, apparently, even less fitted to 
combat the attacks of time. 



48 ON HEALTH AND LONG LIFE. 

INFLUENCE OF SEX. 

The sex considerably affects the probability of life. 
In spite of their feebler constitutions, their numerous 
diseases, and their exposure to the risks of maternity, 
it is the women who live the longest. Any one who 
counts up his acquaintances, will be pretty sure to find 
that the number of old ladies above seventy is greater 
than that of the other sex. Nevertheless, the most 
astonishing instances of longevity on record are exclu- 
sively of males. Probably the true reason of the 
larger number of elderly women is that, as a sex, they 
are less exposed to physical danger and fatigue, to 
harassing mental strain, to irregular hours, to habits 
of dissipation and excess, and to the perils which at- 
tend the avocations of the soldier, the sailor, and the 
explorer. 

HEREDITARY TENDENCY. 

Hereditary tendency goes very far in determining 
the length of our lives. We have elsewhere drawn 
attention to this, and shown how old age is in many 
instances a family heirloom. This does not necessa- 
rily mean that a sound constitution is transmitted from 
father to son. On the contrary, it is a suggestive fact, 
that persons of uncommonly feeble physical powers 
survive the members of their family who in earlier life 
were the more vigorous. "Where the parents and 
grandparents have attained a green old age, the pre- 
sumption in favor of long life is very strong. 

It is so well known that longevity is an heirloom in 



MONEY BUTS LONG LIFE. 49 

families, that the life-insurance companies inquire with 
great minuteness into this point. Accidents and acute 
diseases aside, each living individual will probably live 
to the average age of his ancestors, and not beyond it. 
One of the descendants of Thomas Parr (whom we 
have mentioned above), by name Michael Michael- 
stone, lived to 127 years. 

MARRIAGE OR CELIBACY. 

"With regard to this, the remark is made by the 
celebrated Dr. Hufeland, that all those who have 
attained extraordinary old age have not only been 
married men, but, when already quite old, have married 
for the second or third time. The celibate life, in 
either man or woman, is not the longest life. Various 
reasons explain this, the most obvious of which are 
the lack of attendance in illness, the pressure of un- 
satisfied longings, the greater temptation to irregu- 
larities and to lowness of spirits. Whatever may be 
the cause, the fact is so indisputable, that the statisti- 
cian Casper has estimated that at the age of seventy 
years there are more than twice as many married 
persons living as single, in proportion to the number 
of each in the population. "We are justified, then, in 
placing marriage as one of the essential elements of 
longevity. 

OCCUPATION AND SOCIAL POSITION". 

The trade or profession and social standing of per- 
sons influence very directly their chances both for 

4 



50 



ON HEALTH AND LONG LIFE. 



health and long life. Indeed, those who have given 
time to the investigation of the causes of longevity 
have thought it important to devote to these their 
particular consideration. "We have no wish to burden 
our readers with the long tables which their pages 
contain, and will rather give in a few lines what the 
results of such studies have been. 

The simplest division of society is into the rich and 
the poor. "We are often told of the many good things 
which cannot be purchased by gold; and often long 
life is included in the list. But this is not altogether 
correct. On the contrary, we find in all parts of the 
world that the wealthy, as a class, are longer-lived 
than the indigent. The reasons are obvious. They 
can protect themselves more completely against the 
weather, they can eat better food, they can guard more 
sedulously all the avenues of disease, and, when ill, 
they can command more skilful medical advice. This 
is so true, that in the registration returns of Boston, 
where the statistics are very carefully kept, the " gen- 
tlemen" — that is, in our American mode of speaking, 
those who live on their incomes and have no regular 
business — are the longest-lived of any of the classes. 
A French writer had the idea of collecting the names 
of all the princes and sovereigns of Europe, and all 
the nobility of England and France, and compared 
their mortality with that of an equal number of 
persons from the laboring classes. To his astonish- 
ment, he found that two of the latter died to one of the 
former ! 

Of those who do " work for their living," to use a 



SOME TRADES AEE POISONOUS. 51 

homely but striking phrase, those attain the greatest 
age who belong to the "learned professions," the 
ministry, the law, and medicine, and in the order in 
which we have named them. It may surprise some 
to see the physicians appear last. They who are the 
instructors of others, do they neglect their own coun- 
sels ? and, 

"As some ungracious pastors do, 
Show us the steep and thorny way to heaven, 
And reck not their own read ?" 

ISTo; but the nature of their avocation destroys all 
habits of regularity in sleep and meals, exposes them 
to contagious maladies, and allows no time for that 
rest of body and mind so essential to preserve the 
powers. 

The clergy have, in all these respects, the advantage 
over them. They attain an average age of about 
fifty-seven or eight years in this country; lawyers 
about fifty-five, and doctors but fifty-two or three. 

Farmers, by which we do not mean farm-laborers, 
are, in healthy districts, quite equal in longevity to 
professional men. In their case, very much depends 
on the climate and soil of their localities. On the 
northern plateaux of our country they attain an aver- 
age age of sixty years; but in the southern States, 
where they are exposed to dampness and swamp- 
poison, they appear less favorably on the record. 

The various kinds of mechanical trades are all less 
healthful than the foregoing. Certain occupations act 
directly upon the health. The stonecutter, the cutler, 
the foundry man, and the factory operative, all pass 



52 ON HEALTH AND LOM LIFE. 

their hours of labor in an atmosphere loaded with an 
irritating though invisible dust, which accumulates in 
their lungs, and in time interferes with the general 
health. Again, printers, tailors, shoemakers, and 
similar laborers, have little opportunity to take exer- 
cise and enjoy fresh air, and are obliged to remain in 
cramped postures for much of their time. Sewing- 
machine operators are liable to some special diseases 
from the motion of the treddles, and some branches of 
manufacture force the employees to work amid the 
fumes of poisonous metals, as lead, phosphorus, and 
arsenic. That their avocations must shorten their 
days is too plain to need any emphasis. 
We shall now state briefly what are the 

SIGNS OF A LONG LIFE. 

First is the hereditary right to one, because the 
parents and grandparents enjoyed the privilege. 

A sound constitution ; not necessarily great strength, 
but freedom from tendency to any special disease. 

A faculty of recovering rapidly from injuries and 
illness, and a power of endurance of fatigue and pri- 
vation. 

A mental character not readily depressed or exalted, 
not excitable, and generally hopeful, courageous, and 
calm, the passions and appetites well under control. 

A social position which allows every care to be 
given to health, and lifts one above the distress and 
anxiety of struggling for daily bread. 



WHO WILL LIVE LOXGT. 53 

A perfect balance of the different organs and func- 
tions of the body. 

Habits of activity, regularity, and moderation. 

To be happily married, and surrounded with a 
promising family. 

These are the requisites for him who has a right to 
look for length of days. Let them be carefully studied, 
and those that can be acquired, let them be sought 
after. They mean not long life only; they bring with 
them health and peace. 

But we do not intend to leave the reader in these 
generalities. They are too vague for him, perhaps, 
and we shall accompany him, therefore, into the study 
of the minutiae of these directions, and, line upon line, 
precept upon precept, indicate precisely what he is to 
do and not do, in the various relations of his life. 

Our plan shall be to commence with the bodily 
functions of the individual, his food and drink; then 
pass to his externals, his clothes, his toilet, and his 
house; next, to the use he makes of his powers, intel- 
lectual and physical ; and, finally, to the rest he should 
take, whether as recreation or as sleep. "We shall 
then specify certain precautions he should observe to 
guard himself against epidemic diseases, and conta- 
gion of various kinds, to which he may be exposed. 
In other words, before we begin to speak of the 
methods of healing the disorders to which the race is 
liable, we shall recommend the ounce of prevention 
which is ever worth the pound of cure. 






msB&mSmti&m 



CHAPTER IT. 

ON FOOD. 

Section I. Animal Food. Milk — Butter — Eggs— Beef and veal— Mutton 
and lamb — Pork — Salted meats — Fat and lean meat — Fowls — Game — Fish 
— Shell-fish — Diseased meats and their detection — Poisonous flesh — Dis- 
eased and poisonous milk — Poisonous honey. 

Section II. Vegetable Food. Starch — Sugar — Bread — Vegetables — Poi- 
sonous confectionery. 

Section III. Spices and Condiments. Salt— Black pepper— Red pepper 
■ — Mustard — Vinegar. 

Quantity of Food — What we shall eat — Hours of meals— Cookery — Adultera- 
tions of food. 




PROPER classification of the different varie- 
ties of food made use of by man has yet to be 
proposed. Of the many which have been offered, not 
one is acceptable to both physiologists and chemists. 
"We shall attempt none, but proceed, without discuss- 
ing theoretical views of any kind, to explain the rela- 
tive nutritive powers, the methods of preparation, and 
the dangers attending the various articles of diet, 
under the simple division of animal food, vegetable food, 
and spices and condiments. 



I. Animal Food. 

This embraces all aliments which are derived from 
the animal kingdom. Some hygienists reject them 

(54) 



VALUE OF ANIMAL FOOD. 55 

altogether, with one or two exceptions, on the ground 
that man is an "herbivorous" or else a " frugi vorous" 
animal, and will live longer and enjoy better health, 
the less he has to do with meats. This is a vagary 
founded on anatomical fancies, which neither sound 
science nor experiment confirms, and is not likely to 
attain wide acceptation. It is indeed possible that in 
individual cases, and under unusual circumstances, 
persons are stronger and healthier without a flesh 
diet, but, as a general rule, this has no application. 



MILK. 

This is the earliest and for many months the exclu- 
sive food of our species. It combines in itself all the 
elements necessary to sustain life, and is by most 
infants and adults well liked and readily digested. 
Some persons, however, suffer from colicky pains after 
taking it in quantity, while others do not think it pala- 
table. Both will find their objections to it removed by 
boiling it, and using it warm or cold, and sweetened if 
desired. 

It is quite fattening, and the use of it should be 
persisted in after the age of childhood. Dr. Edward 
Smith, of London, an eminent authority, attributes 
much of the scrofula and consumption which occur 
in children about the age of twelve and fifteen to the 
general cessation of the use of milk at that period. 

Whenever the system is much exhausted, and there 
is a growing tendency to emaciation, a milk diet can 
be resorted to with every prospect of success. It 



56 OK FOOD. 

should be taken, not iced, as is the fashion of the day, 
but as fresh from the cow as possible, and slightly 
warmed. In this condition it is more digestible. A 
milk diet means the consumption of three or four 
pints daily. Persons of a spare habit would do well 
to take at least a pint daily, preferably at the morning 
or mid-day meal. 

Cow's milk is almost the only variety used in this 
country. That of the Alderney cow is richest, and 
therefore most desirable for adult use. In our cities, 
very much of the milk is of inferior quality, either 
drawn from "slop-fed," unhealthy cows, or mixed with 
stale milk, or adulterated with water. From this 
cause results in a large measure the excessive and 
alarming infant mortality. 

Skim-milk is deprived of its butter and richer 
ingredients, and is therefore less nutritive, but has 
excellent medicinal effects in certain diseases of the 
kidney. Buttermilk, long regarded as quite undesira- 
ble for food, has recently been highly extolled as an 
aliment for infants, at once healthful and palatable. 
It has also been used with considerable success as an 
article of diet in obstinate cases of dysentery. 



BUTTER 

Contains the fatty elements of milk. It is used with 
great propriety with bread and other starchy sub- 
stances, as it not only renders them more palatable, 
but also more digestible, and more nourishing. Its 
liberal use is especially to be recommended to those 



HOW TO PREPARE EGGS. 57 

who are too spare in flesh, and those with a tendency 
to scrofula and consumption. 

EGGS 

Provide in their contents whatever is requisite to 
form and nourish the unborn animal. The yelk dif- 
fers from the white chiefly in containing less albumen 
and a quantity of oil. 

They are found by most persons to be most digest- 
ible when boiled just sufficiently to harden the white, 
bnt not the yelk. Thus prepared, they constitute an 
admirably condensed article of diet. Persons of quite 
delicate stomachs will do well to reject the white al- 
together, and eat only the yelk, which is more nutri- 
tious and easy of assimilation. It is hardly necessary 
to add, great care should be taken to make use of 
those only which are perfectly fresh, as the least stale- 
ness unfits them for food. 

"When either raw or boiled hard, or prepared as fried 
or scrambled eggs, they are not so digestible as when 
boiled as above described. 

BEEF AND VEAL. 

Cattle are raised in all parts of our conntry for 
slaughter, and their flesh, when young in the form of 
veal, and when older as beef, forms the staple of flesh 
diet in the larger number of States. Beef from 
stall-fed steers about three years old is probably the 
most nutritive and finest meat in the world to the 
cultivated taste. It is juicy, easily digested, and 



58 ON FOOD. 

tender. It is best when roasted or broiled, and rare. 
The " roast beef of Old England" merits all the praise 
it has received from the poets. !N"o food is comparable 
to it in life-sustaining and gastronomic qualities. 
Raw beef, pulverized and seasoned, has been found of 
singular efficiency in consumption, chronic diarrhoea, 
and the wasting diseases of children. It is by no 
means unpalatable. 

Veal is less digestible than beef. It should only 
be taken at breakfast or at an early dinner, and always 
well done. Persons of a dyspeptic turn should not 
use it. 

MUTTON AND LAMB. 

These, especially the latter, have the reputation of 
being less "hearty" and more delicate than beef. 
They suit, especially when roasted or broiled, some 
dyspeptics who cannot eat other meats without sensa- 
tions of discomfort. They should be cooked slightly 
rare, and, of the two, lamb is the more digestible. In 
fact, except in the instance of veal, the flesh of young 
animals is always more digestible than that of old ones 
of the same species. 

The sheep is subject to very many diseases, espe- 
cially consumption, rot, and parasites of the skin, liver, 
and brain, which doubtless lessen the excellence of its 
flesh as food. These complaints sometimes, but not 
always, alter the appearance of the meat after slaugh- 
tering. Sheep's livers are so often diseased, that we 
advise our readers to abstain from them altogether. 



IS PORK HURTFUL? 59 

PORK. 

Some of the most popular of our national dishes 
consist largely of the flesh of the hog; witness, for 
example, .the " pork and beans" of New England, the 
" pork and greens" of the Middle States, the " bacon 
and apples" of Illinois, the " hog and hominy" of the 
South, the " sausage and scrapple" of Jersey, and the 
"ham and eggs" of everywhere. The pork-packing 
trade of the "West is one of the most important local 
industries. 

This immense consumption of pork continues in 
spite of violent opposition from various sources. The 
Jews, it is well known, refuse to taste the "accursed 
flesh;" certain hygienists insist that it produces 
physical degeneracy; it is said to cause fatal diseases; 
and to it has been attributed that terrible disease, 
scrofula. It is true that scrofula is derived from a 
Latin word (scrofa) which means a sow, but not 
because the old Romans imagined the disease arose 
from eating swine's flesh, but simply because one 
whose jaws are swollen with scrofulous swellings was 
supposed to resemble in this feature the pendent jowls 
of a hog. 

"We have no hesitation in saying most emphatically 
that the flesh of .a healthy hog is just as good food as 
that of any other animal. It is digested with less 
facility than that of either cattle or sheep, and may 
therefore disagree with some who can eat these, but 
in all other respects it is quite as unobjectionable. 

Although the habits of swine are so filthy, they are 



60 ON FOOD. 

a healthier animal than the sheep. Of the diseases to 
which they are liable, two especially interfere with 
£heir value as food. These are the measles and 
trichinae. "Measly pork" can be distinguished by its 
milky and slightly striped appearance, and the .absence 
of a uniform, bright, clear color. "When eaten, it is 
supposed to favor the development of worms in the 
bowels. The trichina is a very minute worm which 
propagates with rapidity, and makes its home in the 
muscles. It is transferred from the hog to man by 
consumption of pork insufficiently cooked. The Ger- 
man habit of eating raw ham in sandwiches favors 
this transmission, and should be avoided. If pork is 
thoroughly well cooked, as it always should be, there 
is never any danger from this source. Moreover, in 
spite of the much that has been said about trichinae 
of late years, they are found extremely rarely in the 
swine of this country. 

In feeding hogs, the refuse and offal generally given 
should be supplanted by grain, pumpkins, and steamed 
roots. Their flesh becomes on this diet better tasted 
and healthier. The celebrated "Sherwood hams" 
owe their famous flavor to the acorns obtained from 
Sherwood Forest, on which they are fattened. 



SALTED MEATS. 

All the above varieties of flesh are preserved for 
use by salting and pickling. This process very 
materially alters their character. Salt meat is one- 
third less nutritious than fresh, and is likewise less 



THE CAUSE OE SCURVY. 61 

palatable and less digestible. The brine extracts 
many nutritive elements, some of which are essen- 
tial to the maintenance of health. When persons 
are fed exclusively on salt meat, no matter how un- 
restricted the supply, they are certain to suffer, not, 
as is sometimes supposed, because the salt injures 
them, but because they are inadequately nourished, 
Every one is familiar with the fact that scurvy is a 
disease which prevails especially among sailors on 
long voyages, who have no fresh meat. It was com- 
mon among some regiments during our late war, from 
the same cause, and we have seen it in families who 
lived too exclusively on corned beef and salt pork. 

Salt meats should be boiled, as they are thus more 
palatable, and the fluids of the stomach act on them 
more promptly. In all cases, fresh meat should be 
taken as often at least as salted. 



FAT AND LEAN MEAT. 

The hygienist agrees with the epicure in prizing a 
joint that displays "a streak of fat, and a streak of 
lean ;" in other words, both these should be eaten. 

The lean affords the material for bone and muscle ; 
the fat, for the blood and for warmth. Those races of 
men who pass their lives amid the Arctic snows love 
to feed on oil and blubber, and to an Esquimaux no 
more prized tidbit can be offered than a score or so of 
tallow candles. On the other hand, the Hindoo 
laborer, who is hard worked under a tropical sun, and 
hardly knows the sensation of cold, lives on rice, and 



62 ON FOOD. 

cares nothing for fats. These different appetites are 
natural instincts, which prompt each to prefer that 
which is best for him. 

But the appetite is not always so true a mentor. 
"We constantly notice pale, scrofulous, and consump- 
tive young persons of both sexes who have an aver- 
sion to fat meat, when it is precisely what their 
system requires. Children should be encouraged and 
urged to like fat. Did they take it more freely, there 
would be less necessity to administer it to them in the 
form of cod-liver oil. The use of table oil, which is 
much more limited in this country than in southern 
Europe, likewise has an excellent influence on feeble 
lungs, and might with advantage be extended. 

Fat meat should be well cooked, and of its varieties 
mutton fat is that which in debilitated constitutions 
is most beneficial. Mutton suet boiled with milk is 
an excellent food in wasting diseases. 

FOWLS. 

The flesh of fowls is drier than that of the large 
animals we have mentioned, and is ordinarily easy of 
digestion. It is particularly suited, therefore, for 
persons of delicate stomachs. The white meat is more 
tender than the dark part, but not so juicy, nor so 
highly flavored. Most of the domestic breeds are 
healthy, when properly cared for, and their meat 
generally is sound and wholesome. 



THE F^ESH OF WILD ANIMALS. 63 

GAME. 

In the majority of instances, the flesh of wild is 
more tender than that of domestic animals, and at the 
same time has a more decided flavor. The latter arises 
probably from the different habits and variety of food 
which they adopt, while domestic animals have a much 
greater uniformity of diet and conditions. Both 
qualities recommend it to the hygienist and the gour- 
mand, and excuse to some extent the severity of the 
game-laws which are in vogue in the thickly settled 
countries of Europe. 

Venison, which with us is still abundant, is a most 
wholesome and toothsome meat, and the same may be 
said of the flesh of squirrels, rabbits, wild-fowl, " and 
such small deer." 

Turtles, which are caught in large numbers in many 
States, are in rightful esteem. They are very nutri- 
tious, and by no means indigestible for well persons. 
The usual method of cooking them, with wines and 
spices, is too rich for many, and might be simplified 
with advantage. 

Still more delicate are frogs. The prejudice which 
used to exist against them as an article of food is 
rapidly disappearing, and will certainly vanish after 
the first mouthful has been swallowed. Their flesh is 
exceedingly tender, white, and delicious. 

FISH. 

Fresh fish are to be highly recommended as a food, 
even for invalids, and those who suffer more or less 



64 ON FOOD. 

with indigestion. The flavor of some varieties, as 
the trout and salmon, is unsurpassed, and the flesh is 
highly nutritious. They should always be fresh, how- 
ever, as a very few hours suffice to destroy both their 
flavor and their wholesomeness. 

Tlje smaller varieties are generally fried, which is 
the worst possible mode of preparing them for a 
delicate stomach. Broiled or baked, they are much 
superior. It is well to remember that at certain sea- 
sons of the year some kinds of fish become to some 
extent poisonous, and their flesh causes sickness of 
the stomach, and general discomfort. The rockfish 
is an instance, and all fish when spawning are less 
desirable as food than at other times. 



SHELL-FISH. 

The most important article under this head is the 
oyster. This is excellent food, readily digestible and 
very . nutritious. They are preferable either raw, 
roasted, or panned. Care should be taken that they 
are alive when opened, and the old rule that they 
should not be eaten in any month without an r in its 
name is founded on wisdom, for these are their 
breeding seasons, and they are apt to be soft and milky. 
Salt oysters are more digestible than fresh, and they 
should be taken before rather than after other food. 

Clams, on the other hand, are very indigestible, and, 
if taken at all, should be chopped very fine and made 
into soup. 

Lobsters, crabs, shrimps, etc., may be mentioned in 



WHAT MEATS TO AVOID. 65 

this connection. They all belong to the less digest- 
ible class of aliments, and should be altogether 
eschewed by delicate persons. In some individuals 
they cause severe colic, and an eruption on the skin 
known as nettle-rash. They are inferior in all 
respects to the finer species of fish. 

DISEASED MEATS AND THEIR DETECTION. 

"While we have been at work upon the present 
volume, we have observed no less than three convic- 
tions of butchers for selling diseased meats recorded 
in the public papers. For every one convicted, 
hundreds kill and vend diseased stock with impunity, 
and even put on sale the flesh of animals which have 
died of contagious diseases. It is well known how 
prevalent these maladies have been of late years, and 
there is no question but that much sickness has origi- 
nated from the consumption of the flesh of diseased 
animals. 

Every one should learn how to distinguish fresh 
and healthy meat from that which is diseased and 
approaching putrefaction. 

Fresh meat should not be too fat ; it should be firm 
and healthy-looking and not too yellow, and not 
bleeding at any point. Butchers sometimes rub 
melted fat over the carcasses of thin and diseased 
animals, to give them the glossy look of health. 

The muscles should be firm and somewhat elastic, 
and hardly moisten the finger, not tongh; the pale, 



66 ON FOOD. 

moist muscle marks the young animal, the dark- 
colored the old one. 

When good meat is placed on a white plate, a little 
reddish juice frequently flows out after some hours. 
Good meat has little odor, and this is not disagree- 
able, whereas diseased meat smells faint and sickly, 
and is soft and wet. Healthy meat is neither of a pale 
pinkish nor deep purple tint, but has a slightly marbled 
appearance, from the little veins of fat, and the fat of 
the internal organs especially is firm, hard and suety, 
and never wet. There should be no paleness nor 
change in the appearance in cutting across some of 
the muscles ; the interior of the muscle should be of the 
same character, or but little paler than the exterior; 
there should be no softening, sticky fluid, nor pus in 
the body of the meat. The flesh becomes soft and tears 
easily when stretched in the commencement of decay. 

Under the microscope, the fibre should be clear and 
well defined, and free from animalcule; while that of 
diseased meat is sodden and tumid, as if it had been 
soaked in water, the transverse streaks are indistinct 
and wide apart, and animalcule frequently abound in 
it. 

The degree of freshness of meat when putrefaction 
begins is judged of by the color, which becomes paler; 
by the odor, which becomes at an early stage different 
from the not unpleasant odor of fresh meat ; and by 
the consistence. Afterward, the signs are marked; 
the odor is disagreeable, and the color begins to turn 
greenish. It is a good plan to push a clean knife into 
the flesh, up to its hilt. In good meat the resistance 



ON DISEASED MEAT. 



67 



is uniform, in putrefying meat some parts are softer 
than others. The smell of the knife is also a good 
test. 

The marrow of the hind legs is solid, twenty-four 
hours after killing ; it is of a light rosy red. If it is 
soft, brownish, or if there are black points or spots, the 
animal has been sick, or putrefaction is commencing. 
The marrow of the fore legs is more fluid, something 
like honey, of a light rosy-red color. 

In cattle which have died of pleuro-pneumonia, or 
rinderpest, the flesh is flabby, and when cut a glairy 
fluid drips from it. On the first day it is unnaturally 
red, but on the second and third turns to a dark 
brown. 



A HINT FOR THE COOK. 

"Whenever there is any suspicion attached to meat, 
but not enough positively to reject it, the precaution 
should be observed to cook it thoroughly well done. It 
has been ascertained that heat, which is a powerful 
disinfectant, will destroy the germs of disease, and 
the life of animalcules, and render even decidedly 
diseased flesh almost or quite harmless. This pre- 
caution should always be observed in cooking pork, for 
a pig with the trichina disease may be at trie time of 
killing in apparently perfect health. Yet whoever eats 
the smallest morsel of the lean meat of the animal 
without first killing the parasite in the flesh, becomes 
surely affected with one of the most painful and ter- 
rible, although fortunately not one of the most fatal, 
of diseases. 



68 ON FOOD. 

POISONOUS FLESH. 

Every one should know that both domestic animals 
and wild game occasionally feed on herbs and berries 
which give their flesh a poisonous property, when 
eaten. Sometimes sheep browse on plants which 
impair the healthfulness of their mutton, and those 
who partake of it are seized with violent pain, 
vomiting, and purging. 

Still more serious are the symptoms which ensue 
after eating the flesh of partridges that have been 
feeding on laurel-berries, a very abundant fruit in 
some districts in the fall of the year. These berries 
contain prussic acid, one of the most fatal and rapid 
poisons to man, and the amount which is absorbed by 
the flesh of the bird will lead to alarming and even 
mortal symptoms. "Within the last few years several- 
such cases have been reported in New York and 
Boston, and people cannot be too careful how they 
indulge their appetite on the flesh of this fowl. 

UNHEALTHY FISH. 

We have already incidentally referred to the poison- 
ous character of some fish at certain seasons. In the 
hot months all kinds are less salubrious than in cold 
weather. Even though packed in ice they lose flavor, 
and are not so fit for the table. Especially lobsters, 
mussels, eels, catfish, and oysters acquire poisonous 
qualities. In the south, the catfish is never eaten; 
and instances are reported where in the summer 



AN INDIAN PRECAUTION. 69 

months it has brought on very alarming symptoms. 
Sick- stomach, headache, eruptions on the skin, diar- 
rhoea, and colic, with severe prostration, may follow. 
The cause of these symptoms is unknown, as no 
difference in the fishes' meat can be detected, but it 
probably depends upon the food they obtain at these 
seasons. The ancients knew the circumstance well, 
and attributed it to the moon. 

Doubtless there is something in this opinion. 
The native Indians of our country, and also the hunters 
and trappers who have long lived among them, refuse 
to partake of flesh or fish which has been exposed to 
the moon's rays for several hours, alleging that it 
thereby acquires deleterious properties. 

ON POEK-EATING. 

That pork, or swine's flesh in any of its forms, is 
poisonous when in a healthy condition, is a popular 
notion which we have been at pains to denounce. 
But it is undeniably true that there occur instances of 
poisoning from bacon, ham, sausages, and lard, and we 
mention them, not only so that persons may be on 
their guard, but that such examples may not be cited 
indiscriminately as proving the harmful nature of a 
pork diet. 

Hogs which have died of the "hog cholera" are 
sometimes cured in the usual way by unscrupulous 
dealers, and sold. Their flesh cannot fail to be 
injurious. Lard occasionally is found with qualities 
very irritating to the stomach. This probably acci- 



70 ON FOOD. 

dentally arises from the presence of a certain "em- 
pyreumatic" oil, of poisonous character, which it is 
known is produced when a strong heat is applied to 
a small portion of lard. A few drops of this oil will 
destroy a bird. 

The poison of sausages has become so notorious 
in some parts of Europe, as to have been the subject 
of a prize essay. It was found that they only acted 
in this manner when they were partially spoiled or 
fermented in the interior, which is readily detected 
by the odor. Such instances are very rare in this 
country. Moreover, we generally, and should always, 
confine ourselves to well-cooked fresh sausage, and not 
eat that which has been preserved by salting and 
smoking, as is the usual style in Europe. 

POISONOUS MILK. 

For a year or two, at the most sensitive and frail 
epoch of human life, milk is almost the exclusive food 
of many individuals. How important, then, it is 
that this variety of food should be furnished of sound 
quality, and free from sophistication ! Yet hardly an 
article of consumption suffers more from the unscru- 
pulous hands of dealers. 

Very little of the milk sold in our large cities can 
be recommended even to adults, not to speak of the 
tender infants to whom it is chiefly given. 

But at present we propose to confine ourselves to 
describing some circumstances under which this fluid 



THE QUALITY OF MILK. 71 

acquires poisonous qualities outside of the fraudulent 
acts of milkmen. 

A cow, to give healthy milk, must be herself healthy. 
This statement, simple as it is, is by no means con- 
ceded by dairymen, because their interests are opposed 
to it. But we insist upon it, and repeat that it is 
proven by numerous examples, that milk from dis- 
eased cows is an irritating, pernicious, and poisonous 
fluid, and we firmly believe, on very abundant evidence, 
that a very large part of the mortality of infants is 
due to the use of such milk. 

Cows penned in foul stables, and fed with distillery 
slops, do not yield a product which any human being 
ought to drink. Recent researches in Massachusetts 
have placed the fact beyond doubt, that cows affected 
with that very prevalent malady, the " foot-and-mouth 
disease," give a milk which produces vomiting and 
diarrhoea, accompanied with slight fever, an eruption 
of small water-blisters about the lips, and sometimes 
similar blisters and ulcers upon the body and legs. 
In other words, the milk conveys the disease from the 
brute to the baby. Thoroughly boiling the milk is a 
protection, as the heat seems to destroy the virus of 
the disease. 

MILK-SIOKKESS. 

In the valley of the Mississippi, especially in some 
parts of Indiana, Illinois, and Kentucky, there is a 
much dreaded disease, common both to stock and the 
human race, called the "milk-sickness." Horses, cat- 
tle, and sheep are all subject to it, and it causes most 



72 ON FOOD. 

serious loss to the farmers, as, once contracted, it is 
never recovered from. The legislature of Illinois 
offered for a long time a reward of twenty thousand 
dollars to the person who could discover its cause and 
remedy. It appears after the first frost, and only 
among stock which pastures in or near woods. The 
milk of cows at that time will convey the disease to 
those who drink of it, though butter and cheese made 
from the milk are eaten with impunity, probably 
owing to the neutralizing effect of the salt they 
contain. 

Of course many have been stimulated by the large 
reward to discover the cause of the disease; and there 
seems little doubt but that it arises from some plant 
upon which the cattle feed in the autumn. Several 
such have been suggested, with varying degrees 
of probability. Perhaps that which has had the 
strongest evidence adduced in its favor is the white 
snake-root (known to botanists as the Eupatorium 
ageratoides). But as to a cure, none has been found; 
and as the disease is not only perilous at the time, 
but leaves behind it a long-enduring debility of the 
nervous system, the most prudent plan is to avoid the 
use of milk altogether when travelling in districts 
where the sickness prevails. 



POISONOUS HONEY. , 

"A land flowing with milk and honey," is the 
familiar Oriental figure of speech for a region 
abounding in whatever is necessary to administer to 



HONEY SOMETIMES POISONOUS. 73 

man's necessities and luxuries. But it is well to 
know that even these standard articles of Eastern diet 
are in this country subject to incidental changes 
which not merely deprive them of value as food, but 
assign to them actually poisonous properties. 

Honey, it is well known, is generally collected by 
bees from the flowers of all plants, without dis- 
crimination. To be sure, an insipid variety is pro- 
duced by furnishing the bees sugar and water for 
food, which forms a harmless, but also flavorless, 
honey. Sometimes these busy workers collect their 
stores from the flowers of plants which impart to the 
honey their own poisonous character, and what we 
expect to find a sweet and healthful food proves to be 
fraught with danger to life and health. Of the plants 
whicK thus envenom the sweet, the mountain laurel 
(Kalmia latifolia of botanists), the oleander, and the 
aconite, are sufficiently abundant in some districts of 
this country to render the collection of honey of 
doubtful propriety. The symptoms caused are dizzi- 
ness, dimness of sight succeeded by delirium, which 
is sometimes mild or pleasant, sometimes ferocious, 
resembling intoxication from spirituous liquors, pain 
in the stomach and bowels, convulsions, vomiting and 
purging, and in a few instances death. The treat- 
ment should be to take at once an emetic of mustard, 
or salt and water. 



74 ON FOOD. 

II. Vegetable Foods. 

The vegetable foods are very numerous, and unlike 
in appearance and taste, but to a large extent their 
nutritive properties depend upon the presence of two 
familiar substances — starch and sugar. "What is still 
more singular is, that these dissimilar substances are 
to all intents and purposes in the human body the 
same, as starch when eaten is changed into sugar, and 
the chemical constitution of both* is identical. The 
same is true of their action on the system. They are 
the fat and heat producers, and on this fact hangs the 
whole art and mystery of increasing or decreasing our 
weight. One who is too fat must avoid these articles, 
while he who is too lean should select them. 

But this is apart from our present theme. 

STARCH 

Seems more familiar to us as an article used in pre- 
paring clothes after washing, than as an article of diet. 
Starch for this purpose is derived from the potato, 
and is not suitable for food, as it possesses irritating 
properties. But arrowroot, tapioca, sago, corn-starch, 
and maizena are also forms of starch, more pure and 
more palatable than that from potato. Of these, 
arrowroot and corn-starch are the purest, and most 
eligible. They constitute a light, nourishing, and 
easily digested food for both the well and the sick. 
Arrowroot, which is chiefly obtained in Bermuda, is 
largely adulterated with the inferior varieties, and 



VALUE OF SUGAR. 75 

corn-starch, therefore, which is much cheaper, is often 
quite as good. 

"Whatever form of starch is used, it should be made 
into a paste with a little cold water, and then be 
mingled with boiling water, as it requires considerable 
heat to break the stanch-granule. The special methods 
of preparing dishes from these various articles we 
shall not enter into in this connection ; we will give 
them in the second part of this work, when we come 
to speak of cookery for the sick. 

SUGAR. 

Most of the " sweets" with which we please our 
palates depend for their attractive taste on the pre- 
sence of sugar. In its commercial form this substance 
is usually obtained either from the sugar-cane in the 
Southern, or the sugar-maple in the Northern States. 
It is an eminently wholesome article of diet for most 
persons, in spite of various prejudices which are enter- 
tained against it. Those who work in it, prepare it, 
and eat it freely in a raw state, increase in weight 
rapidly. 

It has a marked preservative effect both on meat 
and vegetable substances, and for this reason is em- 
ployed in the curing of hams, and the canning and 
jellying of fruits. It is present in milk, and is always 
a favorite with the little folks. They are often, poor 
things ! deprived of it, out of a fear that it will hurt the 
teeth, but there is no ground for any such supposition. 

As, however, when taken into the stomach, it under- 



76 ON" FOOD. 

goes a chemical change into an acid, it disagrees with 
many who are troubled with acidity, or indigestion 
associated with heartburn. These, and those who are 
afraid of growing too corpulent, should avoid it. 

Brown sugar is not nearly so pure as white sugar. 
It contains a large quantity of foreign substances, 
and also a peculiar mite or animalcule, called the 
sugar acarus, which bears a striking resemblance to 
the insect which causes the itch, and is said, we know 
not how correctly, to be the cause of that eruption on 
the hands of those who deal in sugar, known as the 
" grocer's itch." 

White or refined sugar is made from brown sugar 
by a process of melting and [dissolving. It is more 
suitable for invalids and preferable for general use. 

BEEAD. 

This all-important article of food, "the staff of life," 
as it is often and appropriately called, is made from the 
flour of several grains, but in our country chiefly from 
wheat and corn. It may be either fermented by the 
action of yeast, to render it "light," or it may be un- 
fermented, either like the Passover bread of the Jews 
and the "hard tack" and pilot bread of soldiers 
and sailors, or lightened by having air forced into it, 
as the so-called "aerated" bread manufactured in our 
principal cities. There is no material difference in the 
wholesomeness of these various modes, so far as has 
been ascertained. The "yeast powders," however, 
which have been extensively introduced into trade of 



THE CEREALS. 77 

late years, are not always innocuous. They consist of 
tartaric acid and carbonate of soda, and if used con- 
stantly are more apt to lead to digestive troubles than 
the use of brewer's or home-made yeast. 

The flour customarily employed has the bran care- 
fully bolted from it. This renders it white, and agree- 
able to the eye, but detracts from its nourishing quali- 
ties. " Whole meal bread," or that made from the 
whole grain thoroughly ground, has been shown beyond 
doubt to be more valuable as food than fine flour. It 
also acts, like bran-bread, favorably upon the bowels, 
maintaining them in a healthy, regular condition, and 
is more fattening. Invalids will do well to prefer it. 

Corn-meal is a great and deserved favorite in this 
country, though hardly known as a food for man in 
Europe. It is fattening and laxative, and requires no 
fermenting to make good bread. Some persons, how- 
ever, have more difficulty in digesting it than bread 
made from wheat. 

Rye is used much less than the above-mentioned 
cereals. It does not differ materially from wheat in 
point of wholesomeness, except that it is not quite so 
digestible, and is liable to a well-known disease, which 
produces the ergot or spurred rye. When this is eaten 
in bread for a length of time, it interferes with the 
nutrition of the body, and may give rise to fatal 
disease. 

Of the numerous 



78 on pood. 

vegetables 

Which furnish our tables, we can only refer to a few. 
Potatoes and beets are perhaps the most nutritious, 
the former containing much starch, the latter sugar. 
Peas and beans are not so valuable as a nutriment, 
though they are very largely employed. They are 
also less easy of digestion. Turnips, carrots, and 
parsnips are watery, and neither so digestible nor so 
nutritive as the preceding. 

FRUITS. 

The prejudice which prevails against eating fruits, 
lest they should bring on disturbance of the bowels, 
etc., is only true so far as it applies to unripe or over- 
ripe fruit. That which is fully ripe and fresh consti- 
tutes a healthful though not very nutritive diet, one 
well adapted to warm weather, and which can be freely 
indulged in without fear of deleterious consequences. 
Even children need not be limited in its use. The 
numerous deaths in summer among children from 
bowel complaints do not arise from this cause, as it 
will be noticed that the large majority of such deaths 
are of children under two years — too young to con- 
sume much fruit. 



POISONOUS CONFECTIONERY. 

It is sad to think that the very means devised to 
delight and reward children should often be the cause 



DANGEROUS CANDIES. 79 

of their sickness and pains. The gay colors with 
which confectioners paint their sugared sweets, so that 
they may please the eye as well as the taste, are too 
often composed of poisonous materials, which, even in 
small quantities, cannot be taken without harm. 

"We have before us a recent report of a chemist who 
visited the principal confectioneries of one of our large 
cities and purchased packages of their gaudy-colored 
sweets, but instead of eating analyzed them. He acted 
wisely, as his report shows. Nearly all the yellow and 
orange colors he discovered to be produced by a 
poisonous salt of lead (chromate); the green were 
many of them tinted with a combination of arsenic 
and copper (cupric arsenite) ; some of the red with 
mercury (mercuric sulphide) ; and the mauve and ma- 
genta with aniline dyes, which are known to be active 
irritants to the skin. He further found some of the 
lozenges and candy-sticks to contain about a sixth 
part of the insoluble white clay known in commerce as 
terra alba; and others to have about as much ground 
plaster of Paris ! 

This is a disagreeable piece of news, but it explains 
how the little folks fall sick sometimes without appa- 
rent cause, and why some people have learned by ex- 
perience that candies are very unwholesome luxuries. 
The fault is not with the sugar they contain, but with 
the adulterations and pigments which unscrupulous 
tradesmen mix with their goods in order to save a few 
pennies. 

Our advice is to avoid all the green, blue, and ma- 
genta-colored confectionery, and if any brilliant hues 



80 



ON FOOD. 



are chosen, the yellows and reds can he made from 
perfectly harmless materials, namely, from cochineal, 
saffron, and turmeric. 

III. Spices and Condiments. 

The question of the propriety of the use of these 
articles has agitated the minds of many writers on 
hygiene of late years. One party maintains that an 
artificial excitement of either palate or stomach is 
injurious, and therefore to be condemned. We re- 
member to have read in one of their essays that " a 
grain of pepper is as poisonous as a grain of strych- 
nine;" and in another, to have seen as many maladies 
attributed to the use of salt as to the abuse of liquors. 

Such extravagances are in no wise defended by the 
words of science. On the contrary, it is proven 
beyond question that the temperate and occasional 
use of condiments facilitates digestion, and benefits 
the general health. Nevertheless, it is equally true 
that, like all other stimulants, their habitual use 
brings on debility of the organ, and, if taken in exces- 
sive quantities, they may induce irritation and inflam- 
mation. "What is true of most, if not all the good gifts 
of Nature, applies with unusual force to them — that 
moderation and reason must set bounds to indulgence, 
otherwise they will do harm. 



SALT. 

The most common is salt. This is contained in 
small quantities in most articles of food as they natu- 



SALT IS WHOLESOME. 81 

rally exist, but not in sufficient amount to satisfy the 
demands of the system. It forms a large and very 
essential element in the blood, and when deprived of 
it, much suffering results. Some generations ago, in 
Holland, it is said to have been the custom to punish 
criminals by confining them and allowing them no 
food but bread without salt. The consequence was 
that they became infested with worms, the blood was 
depraved, and they perished miserably. 

Some have attributed scurvy and similar complaints 
to an immoderate consumption of salt; but experi- 
ments have shown that this is not the case. The 
value of this condiment to the lower animals, espe- 
cially those which feed on grasses, is familiar to every 
farmer. Its revivifying power is such, that if a strong 
solution of salt and water be injected into the veins of 
a person dying with cholera or other rapidly exhaust- 
ing disease, the patient will often be roused from his 
stupor, and instances have been known where it led 
to recovery. Its many uses in domestic medicine we 
shall speak of on a later page. 

The urgent demand for salt meats which is some- 
times witnessed in diseases should be respected as an 
intimation of Nature, and obeyed. 



BLACK PEPPER 

Is the unripe fruit of an East Indian vine. In small 
quantities it is an efficient promoter of digestion, but 
there is no doubt it is often used to excess, and 



82 ON FOOD. 

weakens the stomach by too constant stimulation. 
It should be taken with great moderation. 

RED PEPPER, 

Or Cayenne pepper, is a much more powerful stimu- 
lant than the black, but is not, in proportion to its 
strength, nearly so irritant. In tropical climates, and 
during periods of excessive heat, it enables the sys- 
tem to resist the prostration caused by the high tem- 
perature, and for this reason the Spaniards of Mexico 
and South America are extremely fond of it. 

MUSTARD 

Is a favorite condiment in the United States. It is a 
gentle stimulant to the whole system, and in the pre- 
paration of salads, aids the digestion of those other- 
wise unwholesome compounds. The black and white 
mustards are the products of different species of 
plants, the former being the more powerful, but less 
elegant for table use. Its valuable properties as a re- 
source in the home treatment of disease we shall detail 
in a subsequent chapter. 

VINEGAR 

Is the remaining condiment which we look for in 
every caster. The best is obtained by the fermenta- 
tion of cider and wine, and is therefore called cider 
vinegar and wine vinegar. But much of that sold 
under these names is manufactured by allowing raw 
whiskey to pass through beech-wood shavings, or, 



MARTYRS TO FASHION. 83 

worse still, by diluting sulphuric acid (oil of vitriol) 
with water, and coloring it with burnt sugar. These 
frauds should be punished, as the vinegar thus pre- 
pared is injurious to the health. 

Pure vinegar promotes digestion, adds to the flavor 
of food, and slightly stimulates the whole system. 
Diluted considerably with water, it was a favorite 
drink with the ancient Roman soldiers on fatiguing 
marches,, and is asserted to possess the power of 
preventing scurvy. 

Vinegar dissolves most albuminous substances, it 
therefore promotes the digestion of those aliments. 
It also produces a solvent action upon several vege- 
table principles, and the popular practice of mixing it 
with salad is one to be commended on scientific 
grounds. If vinegar be largely used, it dissolves the 
muscular tissues of the body, and greatly impairs the 
digestive powers. There are ladies who employ this 
condiment, not for the purpose of imparting piquancy 
to their food, but with the object of arresting their 
tendency to embonpoint — in plain English, to exces- 
sive fatness; this practice has often produced serious 
disease, and even death. Many persons are constitu- 
tionally disposed to obesity, and cannot avoid the 
dreaded accumulation of fat, except by bringing on 
themselves more serious evils. 



QUANTITY OF FOOD. 

We have gone with some minuteness into the 
various articles of diet most common in this country, 



84: on pood. 

because we are what we eat, in more than one sense. 
Leaving now these, we shall consider the general rules 
which should govern us in partaking of food, relating 
to its quantity, variety, and the hours of meals. 

The quantity we take is generally regulated by 
appetite. This is a sufficient guide, when it is not 
created by condiments or stimulants. But it is very 
easy to create a fictitious appetite which will lead us 
to excesses at table certain to prove harmful. Highly 
spiced food, liquors before meals, complex and tempt- 
ing dishes, are very certain to tempt us to break the 
golden rule of moderation beyond which lies danger. 
In the well-to-do classes of society there is frequent 
inclination to eat to excess, and it is in that class, 
consequently, we find the most dyspepsia, gout, and 
apoplexy. 

The average American is naturally the largest eater 
in the civilized world. His voracity would appal a 
Spaniard or an Italian, nations which flourish on 
repasts which would strike us as meagre in the 
extreme. The celebrated Venetian Cornaro, who pro- 
longed his life beyond a century, confined himself to 
twelve ounces of solid food a day; the American aver- 
ages sixty ounces a day, and. when engaged in active 
pursuits, it does not seem too much for him. Unfor- 
tunately he often continues this voracity to his own 
damage, when he is engaged in sedentary pursuits. 

The amount we should eat, depends directly upon 
the amount of work we do. The hunter, the laborer, 
or the farmer requires more nourishment than the 
clerk or the student. Occupation, therefore, must 



AN ASTONISHING GLUTTON. 85 

be kept in view in prescribing a diet. So, too, must 
age and sex. Women eat less than men, and an old 
person less than one in middle life. Habit has also to 
do with it, as much depends on how much we have 
heretofore given our stomachs to do. 

From this it will be seen how impossible it is to lay 
down oracularly any diet-table to be adhered to. 

The smallest eaters in the world are the Bedouin 
Arabs. Half a dozen dates fried in butter suffice one 
of them for a whole day. In spite (or in conse- 
quence?) of this most meagre diet, they are a long- 
lived, muscular, healthy race, usually lean and gaunt, 
but with astonishing powers of endurance. 

The largest eaters are also found in Asia, but in the 
far north, on the cold plains of Siberia. The natives of 
this bleak region seem literally insatiable. Travellers 
— trustworthy observers — say that three of them will 
consume a reindeer at a single meal, and that one of 
them will frequently eat forty pounds of meat a day ! 
A Russian Admiral relates that to test the capacity of 
one of them, he gave him immediately after a hearty 
breakfast a dish containing twenty-eight pounds of 
rice boiled down with several" pounds of meat. The 
native was delighted, and cleaned the platter at a 
single sitting! 

There is as much difficulty in saying 

WHAT WE SHALL EAT, 

As how much we shall eat. Here again the part of 
wisdom is for every one to studv his own constitution, 



86 ON FOOD. 

and sedulously avoid whatever he learns disagrees 
with him. But the selection must not be carried so 
far as to bring about a monotony in diet. This is 
never advantageous. "Were one to confine himself to 
the best food, say roast beef and potatoes, after a while 
his system would fail under it, and his blood become 
impoverished. A good proportion is about one-third 
meat and two-thirds vegetables, the varieties of each 
being frequently changed. Meat should be chiefly 
taken at breakfast and dinner. 

HOURS OF MEALS. 

. The time at which we should take our meals is so 
purely a matter of habit, that it is useless to define it 
strictly. In the great cities the exigencies of busi^ 
ness force many men to take a late dinner, at five or 
six o'clock. Farmers and laborers, on the other hand, 
dine at noon, or shortly after. The stomach soon 
accustoms itself to either hour, and, provided that at 
least four hours intervene between the last full meal 
and the hour of retiring to sleep, it makes no difference 
with regard to health. 

Tea or supper, when taken, should be light and 
digestible, and should precede sleep by at least two 
hours. Indeed, nothing whatever should be eaten 
within this period of the hour of sleep. 

Breakfast should be eaten very soon after rising in 
the morning. The recommendation to take a walk, or 
horseback exercise, or an hour or two of study, before 
breakfast, is to be disregarded as contrary to sound 
hygiene. 



THE YALUE OF COOKERY. 87 

A national fault with us is to eat too fast. The 
pressure of our busy lives, and the rattle and clatter 
of hotel tables, insensibly lead us into this bad habit. 

"We pay for it in ruined stomachs, and all the 
miseries of dyspeptic sensations. Food must be well 
chewed, and not thrust too rapidly into the stomach. 
It should not be taken when the mind is preoccupied, 
nor when our spirits are anxious and perturbed, nor 
immediately after or before severe mental or bodily 
exertion. 

Cookery is an art still in its infancy in the United 
States. Our hotels and boarding-houses are standing 
witnesses of how careless and ignorant we are in this 
respect. Their tables would not be tolerated in most 
civilized countries. It is thought almost derogatory 
to a man to be particular about his food. All this is 
a mistake. "We cannot give too much attention to our 
kitchens for the sake of health, if we do it judiciously. 
There is nothing in personal sanitary science that we 
should strive for more earnestly than that 

" Good digestion follow on good appetite, 
And health on both." 

To sum up in a few maxims our advice on these 
important subjects, we present these, which should be 
repeated as regularly as grace itself: — 

Satisfy your appetite, but do not stimulate it ; 

Eat less than enough, rather than too much ; 

Change your diet as often as your clothing j 

Time is not lost which is spent in eating ; 

It sometimes pays better to study a cook-book than a day-book. 



88 ON POOD. 



ADULTERATIONS OF FOOD. 

Even those articles upon which we depend for our 
subsistence have not escaped fraudulent and dan- 
gerous adulterations. "We have to incur in eating, not 
only the perils which may arise from the presence of 
disease or poisonous qualities produced by exceptional 
natural circumstances, but also of injurious substitu- 
tions made by traders with a view of increasing their 
ill-gotten gains. In several States laws have been 
enacted for the purpose of punishing those who can 
be detected in these reprehensible manoeuvres. But, 
unfortunately, it is not easy for the consumer to con- 
vince a jury of these frauds, and there are few who 
care to take the trouble and expense of doing so. 

ADULTERATED BREAD. 

In this country, where grain is so abundant, there 
is little temptation to adulterate wheat flour, and as it 
is brought in the market, it is without fraudulent 
addition. But in making bread in large bakeries, 
substances are added to improve the color, or the 
quality, which are objectionable from a hygienic point 
of view. Of these, alum is said to be one of the most 
prominent. It is added for the purpose of whitening 
the loaf, and its constant consumption would unques- 
tionably finally produce troubles of the digestive organs 
and injure the teeth. The test which chemists apply 
to discover its presence is quite simple. A pure and 
clear tincture of logwood is brought into contact with 



ALUM 1^ BREAD. 



89 



the suspected bread or flour. If no alum is present, a 
pale yellow or straw color is produced; but if that 
substance is in the flour, then instead of the yellow a 
dark red hue is produced. In Europe, magnesia, pipe- 
clay, plaster of Paris, and a white earth called terra 
alba, have been found mixed with flour, in order to 
increase its weight and bulk. Rice flour and potato 
flour, both cheaper than superfine, wheaten flour, have 
also been mingled with the former. Such additions 
as the latter, though deceits and hence to be disap- 
proved, would have no noxious influence on the health 
of the consumer, so that they may be considered almost 
innocent by the physician. 

ARROWROOT. 

Arrowroot is extensively consumed by invalids and 
convalescents, and it were especially desirable there- 
fore that a thoroughly reliable article could be obtained. 
The best flavored and the least irritating is the Ber- 
muda arrowroot; but it is only rarely that any of it 
can be obtained which has not suffered by addition of 
some of the inferior and cheaper starches derived from 
potatoes, corn, or wheat. 



BUTTER A1STD CHEESE. 



Good butter should not contain more than one or 
two per cent, of salt when sold as fresh; and when sold 
as salted, not over seven per cent. But as it is easy 
to add to its weight by increasing the salt, as much 



90 ON" FOOD. 

as twelve or thirteen per cent, is often added. The 
coloring matters which are used to give the yellow 
hue which is so much admired in butter and cheese, 
are mainly mashed carrots, yelk of eggs, and arnotta, 
the latter obtained from a tropical tree found in South 
America. None of these dye-stuffs, as they may be 
called, act injuriously on the health, but it may be 
questioned if they improve the quality of the dairy 
products with which they are mingled. 

"When butter is thoroughly whipped with milk or 
water, it takes up sufficient to increase its weight 
nearly forty per cent. We remember that not long 
since an ingenious machine to perpetrate this fraud 
was actually advertised and sold in this country. Of 
course such action can only be regarded as a bare- 
faced swindle. A spurious kind of fresh butter is 
made in water by dissolving the salt out of cured 
butter and washing the product with sweet milk. 
This stuff is produced in large quantities in some of 
our cities. 

During the siege of Paris artificial butter was 
manufactured from the elements of fat known as 
stearine and margarine; and an eminent scientific 
authority in New York states that thousands of 
pounds are sold daily in that city, of butter adulte- 
rated with the stearine and margarine obtained from 
the refuse of cotton-seed oil. That lard, suet, and 
other fats are frequently used to accomplish the same 
purpose, is well known. Unfortunately, the additions 
are made so skilfully that it is by no means easy to 
detect them on cursory examination. 



THE SUGAR INSECT. 



91 



Cheese, besides the coloring matter above alluded 
to, sometimes contains starch. Instances have not un- 
frequently occurred where after eating freely of cheese, 
persons have been seized with symptoms of acrid 
poisoning. Chemical investigations have revealed 
the presence of small quantities of arsenic and copper 
in such cases. These mineral poisons were probably 
added accidentally in the course of manufacture. 



SUGAR, TEA, AND COFFEE. 

Sugar is nearly always met with in a genuine state, 
though grocers are charged with occasionally adding 
sand to increase the weight, and undoubtedly often do 
add water to the lower grades for the same purpose. 
Lump, and sifted refined sugar should be preferred, 
not only because they cannot be tampered with in this 
way, but also because raw brown sugar generally 
contains vast numbers of a minute insect, called the 
sugar acarus, which strikingly resembles that which 
by burrowing in the skin produces the itch. Indeed, 
the scaly and itching condition of the skin often seen 
in grocers, and called " grocer's itch," is supposed to 
be caused by this insect. 

Tea is said to be adulterated with the leaves of 
many domestic plants, the willow, oak, beech, elm, 
etc. The tea-leaves which have been already once 
used at hotels and large restaurants are sold to dealers, 
who steep them in a solution of catechu — an astrin- 
gent substance — dry them, mix them with fresh leaves, 
and put them again in the trade. Sometimes they 



92 



ON FOOD. 



are dried on plates of copper, to produce a green tea. 
No process can simulate, however, the fine aromatic 
flavor of high-class tea, and this is the best test of its 
purity. 

Coffee, bought in the grain, can be secured free 
from any adulteration except mingling of lower with 
higher grades. It should always be so purchased, for 
the ground coffee offered to the public is nearly always 
adulterated with wheat, rye, beans, chicory, or old 
grounds dried and aromatized by the addition of 
essence of coffee. It is even said that horse-livers 
are baked, dried, and ground up with old coffee-lees 
to restore their flavor ! 

Chocolate is rarely to be obtained pure, and even 
the very best Spanish chocolate is prepared for use 
by adding sugar, starch, and vanilla to the mass. 
These additions are not objectionable, but the same 
cannot be said of brick-dust, Venetian red, and unclean 
grease, asserted by some authors to have been de- 
tected in chocolate cakes offered for sale as a pure 
article ! 

Black pepper, red pepper, and mustard are subject 
to numerous adulterations, but rarely of an injurious 
character. 

On the whole, we believe that in this country we 
are more free from poisonous food-adulterations than 
any of the older and more crowded communities 
where the necessaries of life are demanded by num- 
bers unable to pay for the better class of articles, yet 
unwilling to put up with those within their means. 
"We have little doubt that for every case where health 



THE COOK AT FAULT. 93 

is injured by adulterations of food, there are fifty cases 
where the injury is from carelessness or ignorance in 
its preparation for the table, and that the cook, not the 
grocer, is to blame. 




CHAPTER III. 

DRINKS AND NARCOTICS. 



CONTENTS. 



Water — Tea and Coffee — Chocolate. Temperance drinks: Soda water — 
( Lemonade — Iced tea — Beers. Alcoholic beverages, their use and abuse : 
Distilled liquors — Wines. The cure of drunkenness. Narcotics — 
Tobacco — Opium. Hunger and Thirst. 



E now approach a portion of our subject which 
has been the battle-field of hygeists time out of 
mind. The greatest temptations to violation of the 
laws of life and health seem to present themselves on 
inquiring, What shall we drink? Very few people can 
answer as did the philosopher of ancient Athens, that 
the question seems needless when we have such an 
abundance of so excellent a beverage as water. On 
the contrary, the ingenuity of art and the resources of 
science are taxed to find substitutes for this all-per- 
vading element. 

We are bound to confess, at the outset of the dis- 
cussion, that it is our fixed opinion, drawn from a 
careful study of the subject, that, in spite of the really 
valuable properties which other beverages undoubtedly 
possess, the human race would be healthier and hap- 
pier, had they never sought any other potation than 
that the philosopher recommended. 

(94) 



IMPURITIES OF WATER. 95 

Yet we are not blind to these properties, and we 
shall proceed to assign to each of the popular bever- 
ages the merits and demerits which it actually has. 



WATER 

Itself is not always to be relied on implicitly. Its 
sources of impurity are numerous, and must be care- 
fully guarded against. Rain-water, which is virtually 
distilled water, and therefore pure, is not the most 
wholesome. It is insipid, and acts upon lead pipes 
and vessels, absorbing some of the poisonous metal 
much more rapidly than spring- water. The latter is 
man's true drink. It is freshened with carbonic acid 
gas purified by passing through the natural filter of 
the earthy strata, and cooled by the low temperature 
of the soil. Sometimes it brings with it a store 
of mineral salts from nature's own pharmacy, so 
combined as to surpass the most skilled compound 
of human art. "When these salts are those of lime, 
it is " hard water," not suitable for washing, as soap 
will not dissolve in it. But for a beverage it is 
not injured. Indeed, an experienced physician who 
passed his life in a limestone district has told us he 
feels sure that families raised on this water are of more 
robust build and larger boned than others. For it is 
lime that forms the bones in great part. 

Water which has lain long in contact with vegeta- 
tion becomes contaminated and unfit for use. So also 
when it is drawn from the vicinity of sinks and sewers. 
Bowel complaints of all kinds broke out in our 



96 DRINKS AND NARCOTICS. 

regiments when they were obliged to drink the waters 
of the southern swamps, 

" the gilded pools, 
That beasts did cough at," 

as was so frequently the case. Dr. Snow, of London, 
traced a violent outbreak of cholera in a crowded 
street to the use of water from a certain pump, and 
checked the pestilence by chaining down the pump- 
handle. Often the constant changes from one water 
to another, which travellers undergo, disturb the 
bowels. 

DANGER PROM LEAD PIPES. 

The pipes in which water is conveyed, and the cis- 
terns, basins, and wells in which it stands, should be 
clean and free from injurious mineral substances ; 
especially rain-water used for drinking should not be 
exposed to the action of lead. It is related that the 
inhabitants of Amsterdam became greatly exercised 
at the alarming increase of lead-colic, and other 
symptoms of poisoning by that metal, in their city. 
They employed a skilful chemist to ascertain the cause, 
and he found that it was the increased use of sheet- 
lead instead of earthen tiles for roofs. 

"What pipes are most to he recommended on the score 
of health, has been much debated of late years. Those 
of lead invariably impart a certain amount of that 
metal to the water, and even in the minutest quantity 
it will, in susceptible individuals, give rise to dyspepsia 
and neuralgic pains. Iron pipe is free from such 



THE BEST WATER-PIPES. 97 

objections, but it is not readily adapted to circuitous 
passages in houses. For conducting water from a 
spring in a direct line to the dwelling, it is practicable, 
cheap, and safe. 

The pipes of "galvanized iron," as it is called, pre- 
pared by passing iron pipes through a bath of melted 
zinc, so as to give a thin coating of the latter metal, 
have greater durability, being less apt to rust, and are 
equally unobjectionable. 

Gutta-percha pipes are sometimes used in wells, and 
would seem to be very suitable for this purpose. 

Pure block-tin pipes are excellent on the score of 
health, as the oxide of tin is insoluble, but they are 
rather expensive for general use. 

Quite recently much use has been made of lead pipe 
lined with tin. This material is sufficiently flexible 
to be carried anywhere, and is not expensive. It has 
been longer used in England than in this country, and 
is there highly commended and on good authority. 
Nevertheless, it would seem difficult, if not impossible, 
to entirely prevent in this way contact between lead 
ajid water, and when it does take place, the corrosive 
action would be rather hastened by the presence of 
the other metal. 



EXCESSIVE USE OF WATER. 

Even pure water, great as are its virtues, can be 
used intemperately, and with effects just as ill as 
intemperance with other drinks. One of Napoleon's 
generals, during the famous passage of the Alps, 

7 



98 



DRINKS AND NARCOTICS. 



becoming much heated and exhausted, called for some 
water. A soldier presented him a canteen just filled 
with ice-water from a neighboring glacier. He swal- 
lowed a deep draught, and fell dead instantaneously. 
Many such examples could be adduced. They preach 
a temperance sermon embracing even cold water itself. 
The habitual and inordinate use of ice- water in summer 
is common in this country, and the cause of numerous 
attacks of colic, cramps, diarrhoea, and dyspepsia. 
These consequences are especially to be apprehended 
when the fluid is taken upon an empty stomach. 
"When very thirsty, as after a long walk or on a march, 
it is better first to rinse out the mouth several times, 
then take a few mouthfuls of cool water and a piece of 
bread or cracker, after which small quantities can be 
swallowed at intervals of two or three minutes. 

With food, as at meals, water aids digestion by 
softening and dissolving the solids, and thus allowing 
the juices secreted by the stomach to act more promptly 
upon them. The celebrated Italian, Jacques Casanova, 
relates that he was cured of an obstinate dyspepsia, 
by accustoming himself to swallow several large 
tumblers of water with each meal. And Dr. Hammond 
has shown by experiment that there is no danger of 
diluting the gastric juice by such large quantities. 

HOW TO PURIFY WATER. 



When water contains impurities, it should be boiled 
or filtered before using. Dangerous organic matter 
contained in it may be destroyed by the action of 



HOW TO PUBIFY WATER. 99 

powerful oxidizing substances. The best chemical 
purifier is solution of permanganate of potash; on 
mixing this crimson-colored fluid with impure water, 
it acquires a brownish color. Alum, lime, soda, and 
various other substances are used for purifying water, 
but they are much inferior for that purpose to the 
permanganate solution. 

By filtration through animal charcoal, the greater 
part, and sometimes the whole, of the organic matter 
contained in water may be removed. One pound 
weight of animal charcoal is sufficient to purify from 
fifty to a hundred gallons of foul water; and when its 
powers are exhausted, they may be restored by heating 
the charcoal to redness for a few minutes. 

Some authorities contend that charcoal does not 
perfectly remove the virus of cholera, nor, probably, 
that of any other disease, from water; and if contagious 
diseases are propagated by means of low forms of 
vegetable life, it is most likely that charcoal exercises 
no effect upon such organisms. There are, however, 
putrescent animal and vegetable matters in impure 
water, which, though not specific animal poisons, are 
yet capable of inducing disease if permitted to enter the 
body : these substances are unquestionably destroyed 
by charcoal. By boiling water for about ten minutes, 
the vitality of any living things — germs of minute 
plants, fungi, animalculse, etc. — contained in it is 
destroyed. "When cholera or any similar disease is 
prevalent, it is therefore advisable to boil water before 
filtering it. 



100 



DRINKS AND NARCOTICS. 



TEA AND COFFEE. 



The property is common to many plants to yield 
their taste and virtues to boiling water. Various 
pleasant drinks have been devised in this way, none 
of which, however, equal in popularity tea and coffee. 
A vast amount has been written in praise and dis- 
praise of these universally liked beverages. Their 
active principles are very similar, if not identical, 
and their effects on the system little different. 

To most persons, used with that moderation which 
with all things and at all times is the watchword of 
hygiene, they are harmless, to some positively bene- 
ficial. The moderate stimulation they give the mental 
powers, is rarely followed by a corresponding depres- 
sion of spirits, or nervousness. Whenever this is the 
case, it is a sign that the quantity has been excessive. 
There are a few persons who should touch neither. 
If they feel giddy, or disagreeably excitable, or de- 
pressed, or taste the flavor for some time afterward, 
they should let them alone. But they should not 
insist that that which disagrees with them is harmful 
for all the rest of the world. This is very narrow 
reasoning. 

In hot climates and swampy regions a cup of tea 
or coffee taken in the early morn protects from the 
malarial poison in the atmosphere, and fortifies the 
system against excessive heat. The soldiers in our 
war felt more keenly when the ration of coffee gave 
out, than any other deprivation. While it cannot 



CHOCOLATE IS A FOOD. 101 

take the place of food, it can temporarily silence the 
demands of the system. 

But it is a slow poison, say some. "Very slow," 
replied Fontenelle, the French academician who 
reached the age of a hundred years; "I have used it 
regularly for some eighty years, and it has not yet 
killed me." 

It is wise to use it but once a day under ordinary 
circumstances, and this at the morning meal. Tea 
seems more appropriate in the evening. The effect of 
either on digestion is not marked, and what there is, 
is due much more to the temperature of the fluid than 
the vegetable principle it contains. Drinking it too 
hot, and in large quantities, will very readily disturb 
the stomach. 

CHOCOLATE 

Is an actual food, not merely a stimulant. It is 
manufactured from the fruit of the cacao tree, by 
grinding it with sugar and some aromatic substance, 
usually vanilla. The restorative powers it possesses 
render it peculiarly valuable to those whose nervous 
system is prostrated by anxiety, overwork, or the 
excesses of pleasure. It is less suitable to dyspeptics, 
for it requires some strength of stomach to digest it, 
especially when made with milk instead of water. 

The relative power of these beverages to support 
life was once tested in Russia. Three condemned 
criminals were each given one of them, and nothing 
else. He who had tea lived the longest. But the tea 
given may have been the Tartar tea, which is prepared 



102 DRINKS AND NARCOTICS. 

by mixing tea-leaves, bullock's blood, and salt. So the 
experiment is not conclusive. 



TEMPERANCE DRINKS. 

The opposition to alcoholic drinks on the one hand, 
and the craving of the palate for something beyond 
mere water on the other, have combined in this 
country to invent a number of beverages which are 
usually known as "temperance drinks." We would 
gladly see the list of them much lengthened. The 
most popular and thoroughly American is 

SODA-WATER. 

This is simply ordinary water charged with carbonic 
acid gas to render it sparkling, and flavored with 
various syrups and creams to the taste. There is no 
soda in it, and the name is owing to the fact that 
carbonate of soda was originally used to obtain the 
carbonic acid gas. Now it is manufactured by acting 
on ground limestone with sulphuric acid. 

Soda-water, when carefully prepared and used with 
pure syrups, is a harmless beverage if taken in modera- 
tion. As, however, some of the syrups are com- 
pounded of injurious ingredients, it should be used 
with caution. "We have known a number of instances 
of bowel complaint brought on by its use. 



TEMPERANCE DRINKS. 103 

LEMONADE 

Is a universal favorite in warm weather. Its use is 
refreshing and harmless when taken in limited quan- 
tities. The " lemon syrups," however, from which it 
is often prepared, are usually based upon tartaric acid, 
and are not to be approved from a sanitary point of 
view. The simpler sweetened water — eau sucre — of 
the French is still more innoxious. A cheap and 
wholesome substitute for lemonade in farming districts 
is made by mixing vinegar and molasses with water 
in such proportions as suit the taste. 

ICED TEA 

Has recently come into vogue as a summer drink. It 
is eminently restorative when the system is enervated 
by intense heat, but the alleged injurious effects of 
tea would certainly not be diminished by consuming 
it cold, and by the tumblerful. 

The beers prepared by fermentation with yeast and 
flavoring with ginger, sassafras, and roots of various 
kinds, are simple and agreeable compounds. Mead, 
made by allowing a mixture of honey and water to 
pass to the stage of fermentation, is also, when skil- 
fully compounded, a salubrious and very pleasant 
beverage. It is a pity that the art of manufacturing 
it has fallen almost into decadence since the old days 
when it was deemed a beverage worthy of the gods 
and heroes who quaffed it in the halls of Valhalla. 

Vinegar, impregnated with the flavor of raspberries, 



104 DRINKS AND NARCOTICS. 

blackberries, and other ripe fruit, forms by mingling 
with water a most grateful and luscious summer 
beverage. It is especially appreciated when the sys- 
tem is feverish. 

This list will serve to show that if persons resort to 
alcoholic beverages, it is not because there are no 
pleasant drinks, cooling, well-flavored, and cheap, with 
which to replace them. The advocates of abstinence 
would accomplish much by devising and perfecting 
such beverages, and placing them as easily within the 
reach of those who patronize the dram-shops, as the 
destructive liquors are which they now imbibe. 

ALCOHOLIC BEVERAGES. 

Sugar we have said is starch under a different form ; 
and now pursuing this same substance further through 
the magical transmutations of chemistry, we find it 
reappear as alcohol. For this is a direct product of 
the fermentation of fluids containing sugar. It is at 
the basis of all malt, vinous, and distilled liquors, 
and this it is which imparts to all of them their in- 
toxicating properties. Their effect upon health is one 
of the most important problems of sanitary science, 
and deserves careful consideration. 

Malt liquors are manufactured by fermenting an 
infusion of barley; wines from the juice of the grape; 
and distilled liquors by distilling fermented infu- 
sions or wines. The amount of pure alcohol they con- 
tain varies much. In lager beer the one-twentieth 
part, in wines of average strength the one-sixth part, 



THE EFFECTS OF ALCOHOL. 105 

while in brandies, whiskey, and gin fully one-half is 
alcohol. 

In spite of the vast number of experiments which 
have been made, and the amount of writing which has 
been done upon the subject, medical men are far from 
agreed as to the effect of these beverages, taken in 
moderate quantities and at stated periods, upon the 
system. One party believes that they are at all times 
and under all circumstances unnecessary and injuri- 
ous; the other maintains that they act as food, that 
they retard the waste of tissue consequent upon severe 
muscular or mental exercise, and that they are, there- 
fore, conducive to health, to long life, and to the maxi- 
mum use of one's powers. 

The reason of this diversity lies as much in prepos- 
session and prejudice as in observation. Like the 
effect of tea, coffee, and tobacco, that of alcohol differs 
very much in different constitutions. There are those 
to whom a small amount daily is for the time being 
apparently indifferent, and others, again, whom it 
harms visibly even in the smallest quantities. 

As a tonic in enfeebled states of the system and in 
prostrating diseases, it is sometimes recommended by 
physicians. At times when there is a severe and 
temporary strain upon the muscular and nervous 
energies it is universally used to increase the powers. 

Since the discovery of the process of distilling, 
which is a comparatively modern invention, the con- 
centrated forms in which alcohol has been brought 
within the reach of all, has led to the most deplorable 
abuse of it. The physical debasement and moral 



106 



DRINKS AND NARCOTICS. 



degradation it has caused far outweigh any benefit 
claimed for it, and call for the most strenuous endeavors 
on the part of the wise and good to limit or to do away 
altogether — were such a thing possible — with its use 
as a beverage. The evil is not merely that the even 
temperate use of distilled liquor is injurious to most 
men, which it is, in that it lays the system open to 
disease, and exposes the user to subtle temptation. 
But we cannot and we must not conceal from ourselves 
the frightful insidiousness of this indulgence, the 
strong tendency to transgress the bounds of modera- 
tion, the fatal craving which in some is an inherited 
vice, the fact that even very small quantities weaken 
temporarily the reasoning faculties, and the well-nigh 
universal adulterations with poisonous materials to 
which alcoholic drinks of all kinds are submitted. 

These considerations are of the very gravest 
weight, and fully convince us that, as there is no 
practicable medium between the present excessive use 
of alcohol in this country and total abstinence, the 
public health — not to speak of morals — would vastly 
gain by absolute prohibition of every description of 
alcoholic beverage. Applying this to an individual, 
we would say to him that a single excess proves that 
he is in danger, and he will greatly increase his pros- 
pects of health and life by resolutely abstaining from 
the use of alcohol in any form. 

To those who must or will habitually make use of 
some stimulant, decidedly the best are the malt 
liquors and the lighter wines. The former contain 
some slight amount of nutriment. Lager beer, the 



FOREIGN AND NATIVE WINES. 107 

mildest of them, containing but three or four per 
cent, of alcohol, is very largely consumed in this 
country. When properly made, it is tonic, slightly 
laxative, palatable, and, in any moderate quantity, not 
intoxicating. In some, however, it causes a flushed 
face, fulness in the head, and acidity of the stomach, 
and these should renounce it. Ale and porter are 
similar in manufacture, but nearly twice as strong. 



on wines. 

The majority of so-called foreign wines obtainable in 
this country are manufactured from coarse whiskey and 
the lowest grades of French, Spanish, and German 
wines, colored and scented to imitate the most famous 
brands. This branch of applied chemistry has made 
astonishing progress within a score of years, and it 
draws its resources from most unexpected quarters. 
For instance, one of the most highly prized oils for 
giving a bouquet to champagne is extracted from 
petroleum ! _ These frauds not only delude purchasers 
into buying articles at ten times their value, but are a 
deliberate attack on public health, for most of these 
artificial brands of wine contain ingredients highly 
irritating to the stomach. 

The native American wines, such as are grown in 
large quantities in the Ohio valley, in Missouri, and 
in California, are nearly equal in flavor to the genuine 
imported brands of the best quality, and can be 
obtained of much greater purity. That their use will 



108 



DRINKS AND NARCOTICS. 



diminish the tendency to drunkenness is a doubtful 
assertion, which we would hesitate to indorse. 



IS ALCOHOL BENEFICIAL ? 

The pretence that the use of alcoholic beverages 
enables man to support with more fortitude the ex- 
tremes of heat and cold, or to accomplish more severe 
labor, has been repeatedly and clearly proven false. 
Captain Parry and Dr. Kane, who passed winters in 
the coldest regions of the frigid zone, agree that those 
who abstained entirely from alcoholic drinks suffered 
the least and bore exposure the best. 

On the other hand, an American traveller who 
crossed the Sahara desert from Algiers to Timbuctoo 
in 1859, relates that every one who, to assuage his 
thirst, mingled wine with the foul water carried in the 
goat-skins, died on the journey or even after reaching 
its termination. While those who imitated the rigid 
abstinence of the Arab guides alone survived. 

The most muscular and enduring frames are not 
those heated and stimulated with liquors. This is so 
well known, that prize-fighters and wrestlers, classes 
accustomed to indulgence, resolutely refrain from all 
stimulants when training for a contest. The porters 
of Smyrna, Calcutta, and the Chinese ports, who 
carry loads of 400 and 500 pounds all day long from 
the wharves to the storehouses, use no wine or dis- 
tilled liquors. 



THE REMEDIES FOR INTOXICATION. 109 

THE CURE OF DRUNKENNESS. 

Many a wretched victim of the degrading habit of 
intoxication would gladly escape his ignoble thraldom, 
but has not the courage. He makes now and then an 
unavailing effort to " taper off," or, ceasing entirely for 
a while, is driven back to his accustomed stimulant 
by a dreadful nervousness, a feeling of weakness, an 
impossibility of sleeping, and a gnawing sensation at 
the stomach. More frequently than many are willing 
to suppose, it is a physical craving which drives the 
drunkard back to his cups. 

Altogether too little attention has been given this 
important subject. The question of the cure of 
drunkenness has been regarded too exclusively as a 
moral one, and temperance lecturers have appealed 
solely to the will-power of their hearers. They should 
be prepared to explain what can be substituted for the 
liquor during the first few months of abstinence, until 
the system has accustomed itself to the want of the 
usual stimulus. By this means, they would potently 
aid those who renounce their excesses to keep their 
pledges, and it is this information which we propose 
to give. 

Before proceeding to do so, however, we will glance 
at several plans of cure which have from time to time 
been advocated. The first took its rise in Sweden. 
It is to give the sot a surfeit of his favorite tipple; to 
allow him to have it in any quantity; to impregnate 
with it every article of food and drink he consumes ; 
to have its odor constantly about him. This is said 



110 DRINKS AND NARCOTICS. 

after a few weeks to disgust him utterly and perma- 
nently with it. 

A second plan is to place secretly in the liquor some 
tartar emetic or other nauseating drug, with a view of 
rendering the fluid forever distasteful. This, in the 
hands of an ignorant person, may prove a dangerous 
procedure. 

Thirdly, the proposal of a residence for some months 
in an inebriate asylum remains for consideration. 
These institutions have been organized on an extended 
scale in many States, and their reports record many 
cures. The inmates are not positively deprived of 
their liberty, though they are under restrictions ; and 
the pure and elevated associations with which it is 
sought to surround them, as well as the judicious 
medical supervision under which they live, combine to 
render a reform commenced under such auspices com- 
plete and permanent. For those who can afford the 
time and money of such a retirement, it is highly to 
be recommended. 

But our immediate purpose is to inform our readers 
what course of life the hard drinker must adopt when 
he ceases from his self-destructive habit, and deter- 
mines to renounce it forever. In the first place, he 
must renounce it at once and altogether. Under no 
pretext and in no contingency must he taste a drop of 
alcoholic drink. "Whatever .symptoms arise, he must 
combat by other means. 

His body long used to powerful stimulant will feel 
sorely the want of it. Its place must be supplied in 
the first place by an abundance of animal food. Fresh 



THE REMEDIES FOE INTOXICATION. Ill 

meat should be taken three times a day, either as flesh, 
or as beef-essence, or soup. Milk should be drank 
freely, and several cups of strong coffee may be taken 
in the morning. A strong infusion of Peruvian bark, 
of quassia, or some other vegetable bitter, should be 
drank at the hours when the drams were wont to be 
indulged in. The body should be exercised every day 
up to the full point of fatigue, and idleness and 
inaction, whether of body or mind, conscientiously 
shunned. The free use of tobacco invites stimulants 
by depressing the nervous system, and must be 
renounced. The old habits and associations, whatever 
they were, which favored excess, must be abandoned, 
and the greatest regularity in hours of meals and of 
rest be cultivated. 

The wearing sleeplessness which often accompanies 
the sudden cessation of stimulants is one of the most 
dreaded difficulties to combat. It can be effectually 
overcome by swallowing at bedtime a teaspoonful of 
ether in a half tumbler of water. 

As soon as by these precautions the system has 
recovered its tone, the tonic, the coffee, and the ether 
are to be dropped. This will generally be in two 
months, and the battle will have been fought and 
victory gained without the struggle and the danger of 
defeat which attend generally in perilous force. 

THE USE OF NARCOTICS. 

Our chapter would be incomplete, did we neglect to 
treat of a class of substances which are neither food 



112 



DRINKS AND NARCOTICS. 



nor drink, and yet which are consumed in immense 
quantities throughout our country and the whole world. 
We refer to tobacco and opium. 



TOBACCO. 

Hardly any fact in history is more strange than the 
rapid and universal extension of the use of tobacco 
after the discovery of America. Within these few 
centuries it has spread over the whole civilized and 
uncivilized world, and is as highly prized by the fop of 
the fashionable club, the barbarian of Central Africa, 
or the camel-driver of the Persian desert, as by the 
red man who was the original discoverer of the luxury, 
and who traces its introduction to the gods themselves. 

Like alcoholic beverages, this narcotic weed has 
had and still has its bitter opponents, and its strenu- 
ous defenders. Kings have fulminated their decrees 
against it, and their subjects have submitted to the 
severest penalties rather than renounce it. So ineradi- 
cable and universal is the love of it, that one might be 
inclined to regard it as an indication of a want of the 
system, demanding satisfaction. 

Nevertheless we have proof of the most convincing 
kind that, as frequently indulged in, it leads to numer- 
ous and obstinate complaints. This is, be it under- 
stood, in consequence of its immoderate use. The in- 
crease of its consumption within the last thirty or forty 
years is actually alarming. In France, where it has 
long been a government monopoly, and the amount con- 
sumed carefully estimated, the quantity taxed in 1868 



THE EFFECTS OF TOBACCO. 113 

was more than five times that in 1832! The difference 
was chiefly in segars and smoking-tobacco, the habit 
of snuffing being on the decrease, and chewing being 
almost unknown in Europe. What are the conse- 
quences ? One of the most eminent of French physi- 
cians, Professor Fonssagrives, says that it has been 
productive of very manifest ill results. The tendency 
to dyspepsia, coldness of the extremities, various forms 
of palsy, the notable augmentation of insane persons, 
and the numerous nervous diseases among smokers 
brought to the attention of medical men, prove conclu- 
sively that we have here to do with a positive poison. 

Especially its influence on the intelligence demands 
serious consideration. If any of its effects are well 
established, one is that it debilitates the memory. 
Hence it is peculiarly injurious to students, who exert 
this faculty more than any other. In the public schools 
it is constantly observed that the boys who can commit 
the readiest, and have the most retentive powers, are 
not the smokers. 

Then, too, the most ardent admirer of the Virginian 
weed cannot escape the overwhelming evidence that 
it acts definitely and disagreeably upon the nerves of 
special sense. The taste and smell are rendered obtuse, 
the eyes are weakened, and a peculiar, permanent, 
ringing noise in the ears is caused. 

To sum up our charges against the "weed," we may 
add that recently Dr. Hoffman, of San Francisco, attri- 
butes to it the unpleasant power of producing baldness 
and premature gray hairs, and supports his assertion 
by strong cases and arguments. 



114 



DRINKS AND NARCOTICS. 



These well-attested consequences follow, one or all, 
upon the immoderate employment of tobacco. In 
moderation, it does no harm to most constitutions, 
and is to some apparently beneficial. As to what 
is moderation, and as to who should and who should 
not allow themselves to use it, we shall not attempt 
to say, for here, as in so many other indulgences, every 
man must be "a law unto himself." But we do, most 
unequivocally, condemn its use in any form by growing 
loys. It will be certain to do them injury. 

OPIUM. 

The other narcotics, the opium of the Turks and 
Chinese, the hashish of the Persians and Arabs, the 
kava of the Polynesians, and the cocoa of the Peru- 
vians, are all of them, fortunately, not in use in this 
country to any great extent. None of them benefit 
the health, all of them injure the mental faculties, 
and the wise will shun their cultivation altogether. 

The only one of them to which we need give atten- 
tion is the first mentioned. 



OPIUM-EATING AND ITS CURE. 

The seductive pleasures of opium-eating have 
unfortunately been rendered familiar to the public by 
more than one author of eminence, and many have 
been led into the habit by their descriptions. Others, 
commencing the use of the drug to allay pain, have 
gradually fallen irretrievably under its sway ; while 
there are not wanting many who deliberately seek in 



THE OPIUM HABIT. 115 

its unreal visions solace for the miseries by which they 
are surrounded. Druggists in the over-crowded and 
filthy districts of our great cities have informed us 
that the consumption of the drug by the lowest 
classes of the population is enormous. 

Such indulgence is condemned by every precept of 
physiology and every suggestion of worldly wisdom. 
Soon the wretched victim finds the drug can produce 
no longer pleasurable sensations but only torment; 
and he must determine quickly to renounce it utterly 
or to die. 

When he gives up the use of it, he must for a time 
supply its place, not by smaller doses of some other 
preparation of the drug, as has been recommended by 
some, but by the same methods which we recommend 
under the cure of drunkenness, that is, by tonics, by 
strong coifee, by constant exercise carried up to real 
fatigue, and by the use of ether at night when 
required to produce sleep. 

Sometimes a violent diarrhoea sets in when the 
opium is suspended. It is better not to check this at 
first, but seek, by keeping in bed and the use of simple 
food, to allow nature to discharge from the system 
what is no longer of use there. 



HUNGER AND THIRST. 

When the system is in need of food, we are ap- 
prised of it by the sensation of hunger; when of 
fluids, by the sensation of thirst. In moderate degrees 
these monitors are agreeable visitors, lending a zest to 



116 DRINKS AND NARCOTICS. 

our meals and the best condiments to food. In exces- 
sive degree, they become dreadful torture, and, if un- 
satisfied, soon wear out the body. 

"We cannot say with precision how long a person 
can live without nourishment. The young and strong 
fail first, and with them seven or eight days brings 
the fatal termination. The old and the feeble, w T ho 
need and care less for food, may survive several days 
longer. It has been ascertained, however, that when- 
ever the weight is reduced two-fifths, then death 
ensues. That is, for example, if a person weighing a 
hundred pounds starve himself until he has lost forty 
pounds, he dies. On an average, this occurs in about 
seven days. 

Extraordinary narratives appear from time to time 
in the public prints of persons who, for a long period, 
have lived with little or no food. As a rule, these 
cases rest on deception. A famous one, called the 
"Welsh fasting girl, recently attracted general notice 
in England. A young woman pretended, for a num- 
ber of months, to have partaken of no nourishment. 
She seemed in good health and condition. Several 
physicians became interested in her statements, and, 
to convince themselves, employed watchers to remain 
with her constantly. During this period she died, 
either from starvation or disease, and the scientific 
men were summoned into court to answer a charge of 
murder ! 

The instance of a Scotch woman, Janet McLeod, is 
one of the most authentic. The accounts represented 
that she lived four years without food or drink. She 



HOW TO BEAR HUNGER AND THIRST. 117 

was epileptic and bedridden, and passed most of her 
time asleep. Subsequently she commenced taking 
nourishment, and recovered. 

Naturalists are familiar with the fact that some of 
the lower animals, especially reptiles and insects, can 
exist for months and years without any nourishment. 
Mr. Baker relates that he placed a stag beetle in a 
close box and left it shut up for three years. On 
opening the box at the end of that time, it flew away. 

Persons who are exposed to hunger and thirst 
should be acquainted with the devices for relieving 
those sensations. The Indians and Caffirs are accus- 
tomed, when short of food, to fasten a girdle tightly 
over the stomach. This is found to lessen the sense 
of hunger. They also use tobacco for this purpose, 
which, being a narcotic, quiets for a time the cravings 
of the stomach. Chewing grains of coffee exerts a 
similar effect. 

When he expects to undergo such deprivations, 
the Indian hunter carries with him a small quantity 
of dried slippery-elm bark. A piece of this, half an 
inch square, is placed in the mouth, and relieves to an 
astonishing degree the sharpness of the sensations. 
Hunters have also learned that to hold a bullet in the 
mouth slightly assuages thirst. When short of water, 
the mouth should be kept closed, and but little at- 
tempt at talking should be made. 



118 



DRINKS AND NARCOTICS. 



TO APPEASE THIRST. 



Dr. Franklin recommended sailors who are exposed 
to thirst to wet their clothing in sea-water several 
times a day, believing that absorption through the 
skin would take to some extent the place of drink. 
The suggestion should only be practised, however, 
when the weather is warm. A tepid bath will relieve 
thirst, but a cold one will not. 

After a period of intense thirst it is both unsatis- 
fying and perilous to quaff deep draughts of cold 
water. It will not quench the thirst, but rather 
increase it. If, instead of cold water, a little lukewarm 
tea or milk-and-water be drunk, permanent relief will 
be attained; or if, instead of cold water, a lump of ice 
be taken in the mouth, and allowed to melt there, the 
effect will be agreeable. Juicy fruits and plants are 
very grateful in extreme thirst. Several of the larger 
species of animals, the steinbuck and the porcupine 
for example, satisfy their thirst altogether by browsing 
on succulent vegetables. The use of any alcoholic 
liquor for this purpose is futile, as, after a momentary 
relief, the sensation returns with redoubled intensity. 

The amount of liquid we require is very much a 
matter of habit, as any one can see by recalling the 
differences among his acquaintances. There are many 
persons who almost never drink except at meals, and 
then but very little. Others, in the same conditions 
of health, will be swallowing a tumbler of water every 
hour or two through the day. There was a student 
at the University of Toulouse some years ago who 



HOW TO ALLAY THIRST. 119 

asserted he hardly knew what thirst was, and passed 
several months without drinking. The large propor- 
tion of water in vegetable food, which he chiefly used, 
and the well-known power of habit, render this state- 
ment quite credible. 

The natives of New Caledonia and some of the 
South American tribes swallow a kind of clay to allay 
hunger. The habit is also said to be found in some of 
the Southern Atlantic States. Captain Riley, in his 
Narrative, states that when suffering from hunger 
and thirst on the African desert, he found relief by 
swallowing dried dates whole. 




CHAPTER IV. 

CLOTHING AND THE TOILET. 

CONTENTS. 

Material of clothing : Wool — Silk — Cotton — Linen. The color of clothing — 
Covering of the head — The neck — Underclothing — Boots and shoes — 
Overcoats. The toilet: The teeth — The hair — The skin. 

S it is now, tailors and milliners decide on what 
we shall wear. It might be better, did we call 
to the council wiser heads than theirs, and consider 
health as well as good-looks. For, the clothing we 
adopt influences most materially the condition of our 
bodies. "What the advice of the physician is about it, 
we can say in a few words ; and first as to the 




MATERIAL OF CLOTHING. 

A Prussian general of great age was asked the 
secret of his long life and uniform health. " I drink 
water and wear wool," was the reply, and it embodies 
two sound principles. 

Wool protects the system more completely from 

sudden changes of temperature than any of the other 

materials of which clothing is commonly made. It is 

not so readily saturated by moisture, and when moist 

does not impart the same sense of chilliness to the 
(120) 



WHAT WE SHOULD WEAR. 121 

skin as linen and cotton. It stands pre-eminent, there- 
fore, as a material for clothing in cold and changeable 
climates. 

Silk is more expensive, and to some skins more 
irritating than wool, owing to the amount of electricity 
it develops. It is warm and comfortable to most 
persons. 

Of all the substances used for clothing, cotton is the 
most universally used. "When woven thick and with 
a floss, it is warm, and suited to quite cool weather. 
As it is softer to the skin, many persons prefer it for 
under-clothing to wool even in winter, but it is less 
desirable than the latter for aged and delicate consti- 
tutions. 

Linen, which is manufactured from flax, is of all 
material the lightest, the most agreeable to a sensitive 
skin, and the coolest in summer. It absorbs the per- 
spiration rapidly, and allows the heat of the surface to 
pass off promptly. 

Whatever material is chosen, the under- clothing 
should be changed at least twice a week, except the 
under-shirt, which it is better not to change more 
frequently than weekly. Garments should always be 
well dried and aired before putting them on, and 
should be loose and easy. 

THE COLOR OF CLOTHING 

Is not immaterial to health, as might at first be 
imagined. Dr. Franklin cut a number of pieces of 
cloth of equal size but different colors, and laid them 



122 



CLOTHING AND THE TOILET. 



on the snow one sunny day, to see under which of 
them the snow would melt quickest. As he antici- 
pated, he found quite a difference, the snow melting 
much more rapidly under the darker colors than under 
the lighter ones. He deduced from this that it is 
wiser to wear dark clothing in winter, when we wish 
to obtain and retain all the warmth, and light colors 
in summer, when we desire to suffer as lightly as pos- 
sible from the high temperature. Philosophers since 
his time have endorsed his opinions, and they are in a 
general way acted upon. The difference is consider- 
able. Under a bright summer sun the air in a closed 
jar covered with black cloth will be 12° Pah. hotter 
than that in a similar jar covered with white linen. 
This large reduction of the heat we must put in our 
favor by shunning black hats and black suits in the 
hot season. 



COVERING OE THE HEAD. 

The traditional "stovepipe hat" it seems impossible 
to displace from popular favor. And, indeed, it is 
doubtful whether the attacks against it are all well 
founded. "When constructed with a ventilator, as is 
frequently seen, it keeps the head cool, and protects it 
from injury quite as well as any of the various substi- 
tutes that have been devised. Pelt hats are deservedly 
popular for travelling and exposed pursuits, and cloth 
caps also. The latter should have visors of sufficient 
size to protect the eyes from the rays of the sun. The 
eastern turban, which, excellent as a shield against a 



HOW TO CLOTHE THE NECK. 123 

tropical sun, is deficient in this respect, is to blame 
for the very frequent inflammation of the eyes in those 
countries. 

"Women wear their hair longer, and as a rule to 
advanced age. This allows them to follow the vagaries 
of fashion with more impunity, but the insufficient 
protection afforded by the modern bonnet is proven by 
their frequent neuralgias and headaches. 

THE NECK 

Is a very sensitive part of the body and a frequent 
sufferer from the weather. Coughs, sore-throats, 
quinsies, and hoarseness are too common in our 
climates. There is much difference of opinion and of 
custom about clothing it. The delicately nurtured 
young lady deliberately promenades the streets with 
a low-cut dress and bare neck when the hackmen 
and coachmen are buried up to their noses in woollen 
mufflers. 

Though the ladies are imprudent, the hackmen are 
hardly less so. It is as grave an infraction of sound 
hygiene to wear too much as too little clothing. The 
neck should not be swathed in warm wrappers, nor 
heavy stocks, nor constricted by a tight collar. The 
latter should be loose, the neck-tie of light silk, and 
if, instead of wearing the muffler, the neck be tho- 
roughly bathed in cold water every morning, the 
chances of catching a sore-throat are reduced to the 
minimum. "We have, with difficulty, persuaded some 
persons who complained much of delicate throats, 



124 CLOTHING AND THE TOILET. 

to adopt this " hardening" process, and with gratifying 
success. But it must always be commenced in the 
autumn, not after winter has set in. 

Any constriction about the neck, as of a tight 
collar or cravat, predisposes to vertigo, headaches and 
apoplexy. 

UNDER-CLOTHING. 

The under-clothing, as that which is next the skin, 
should be soft, absorptive, and scrupulously neat. 
Merino, silk, or wool is desirable in cold, linen in 
warm weather. The under-shirt should be of consider- 
able length, covering completely the abdomen. It is 
related of the eminent English admiral, Lord Napier, 
that he delayed his ships several days on one occasion, 
in order to obtain under-shirts for his men, of sufficient 
length, those furnished being too short by a hand's 
breadth. The result was that on reaching the West 
India station, many of the sailors of the other ships 
suffered from dysentery, but those of his escaped 
entirely. The damp air of a summer night is very apt 
to chill the bowels and lead to this complaint, unless 
they are properly clothed. We believe it better in 
hot weather to wear under-shirts of some light fabric, 
like gauze merino. 

Flannel drawers in cold weather are an efficient 
protection. Women especially, whose clothing offers 
so little protection against the cold, should invariably 
wear them in winter. 

Stockings should be worn the whole time, made of 
cotton in summer, and of wool, merino, or silk in 



HOW TO CLOTHE THE FEET. 125 

winter. Some find thick cotton warm enough in 
winter, but the feet are much more liable to be frosted 
with them. 

BOOTS AND SHOES. 

There is a constant outcry against shoemakers, and 
a universal grumbling about corns, but no real attempt 
to escape their tyranny. The obstacle is vanity. A 
foolish notion prevails that in regard to feet the 
Chinese ideal is far ahead of the Grecian. The latter 
maintain that the foot should equal the eighth part of 
the height; the former assert it should be squeezed 
into the utmost possible diminutiveness. 

Following this hint, shoemakers have chosen a 
certain shape to which all feet are pressed, and then 
reduced to the minimum of size. Consequently the 
chiropodists flourish, and corns, bunions, ingrowing 
toe-nails, and hang-nails — all complaints utterly 
unknown to the natural man — give them plenty of 
employment. 

The true shape of the shoe should be that of the 
foot — low heels, very slightly arched, broad at the toe, 
the sole a quarter inch longer and broader than the 
foot when expanded by the weight of the body upon 
it. But who has the courage to wear a shoe of this 
shape? And where is the shoemaker who is willing 
to peril his reputation by making them? "We have 
sought for him in vain. 

Low shoes are less desirable for walkers than those 
which fasten well up around the ankle, and support 



126 



CLOTHING AND THE TOILET. 



that joint. Boots, except for those who wade in mud 
or slush, have no superiority over shoes. 

Overshoes of vulcanized rubber are exceedingly 
popular in our country. They are highly objection- 
able for constant use, and should be reserved for occa- 
sions when without them the feet would be exposed to 
dampness. We have known persons with delicate 
lungs who found it much more conducive to health to 
use overshoes of leather than of rubber. The objec- 
tion to the latter is that it confines the perspiration, 
and keeps the foot in a perpetual moist air-bath, and 
thus renders it very sensitive to exposure. 



OVERCOATS. 

The same objection applies to rubber overcoats. 
They are an unsuitable garment, and an uncomfortable 
one. When used at all, they should be quite loose, 
somewhat like a blanket or a "poncho" (a blanket 
with a slit in the centre, through which the head is 
thrust). This allows the heat and moisture to pass 
off from the body, while it protects from rain. For 
invalids, first-class English pilot cloth is much better 
than any impervious material for an outside wrap. 

Dr. C. J. B. Williams has suggested a device for 
keeping warm worth remembering. He says : " One 
cold winter night I had to go a long journey, and the 
stage being filled, was obliged to ride on the outside, 
although insufficiently clothed for the exposure. Re- 
flecting on the great loss of heat manifested in the 
steaming breath of myself and fellow-passengers, I 



NO COMELINESS WITHOUT CLEANLINESS. 127 

endeavored to save a portion by entirely covering my 
face and head with a silk pocket-handkerchief, the 
lower ends of which were closely tucked inside my 
buttoned coat. The result was an increase of warmth, 
not in the face and chest only, but even in the ex- 
tremities, more comfortable and diffused than an addi- 
tional greatcoat could have produced." 

THE TOILET. 

"We have treated very fully in another work* the 
laws of health which relate to the toilet, and discussed 
at length both the care which sound hygiene deems 
should be observed in respect to it, and also those 
many little arts which heighten the charms of the 
person without detracting from their well-being. 
"We have there shown that health, rightly understood 
and cultivated, is synonymous with beauty, and that 
whoever would have this latter, must begin by the 
assiduous cultivation of the former. 

We do not propose to rehearse in full in this con- 
nection the instructions we have there given. We 
must refer those who would be fully acquainted with 
this attractive and important department of hygiene 
to what we have there said, and confine ourselves 
here to giving some general directions on principal 
points, and to reiterating the fact that nothing is more 
essential to sound health, and the prospect of long 
life, than constant and minute attention to the cleanli- 

* The Laws of Health in their Relation to the Human Form. 



128 



CLOTHING AND THE TOILET. 



ness and the good order of all the external portions 
of the body. 

The three important branches of the hygienic care 
of the toilet refer to the teeth, the hair, and the skin. 
Some writer calls these three " the tripod of health 
and beauty," and we must grant that his fanciful 
expression conveys a solid truth. "We shall devote 
some space to the consideration of each of them, con- 
fining ourselves to direct and practical instructions. 



CARE OF THE TEETH. 

The teeth should be thoroughly washed morning and 
evening, and brushed with a soft brush. After each 
meal the mouth should be well rinsed, and any frag- 
ments of food remaining between the teeth extracted 
with a quill toothpick. Pure soft water should be 
chosen for the purpose, whenever attainable, and none 
is purer or softer than rain-water. 

"When a tooth-powder or tooth-wash is desired, 
it should not be purchased at the stores, where an 
exorbitant price must be paid for an article which 
may prove corrosive and injurious, but a simple, cheap, 
and useful one can be prepared from one of the 
following receipts. 

For a tooth-powder: — ■ 



Take of— 

Prepared chalk, seven drachms. 

Powdered orris-root, one drachm. 
Use every other morning. 



Mix. 



TOOTH POWDERS AND WASHES. 

For a tooth- wash, the following : — 



129 



Take of— 

Tincture of myrrh, 

Tincture of cinchona, 

Cinnamon-water, equal parts. Mix. 
Use a few drops on the brush daily. 



The above is particularly useful where there is a 
tendency to spongy and bleeding gums and to loose- 
ness of the teeth. It can be sweetened with a little 
sugar, if preferred. 

Powdered charcoal is an excellent application for 
the teeth. It should be powdered very fine, and ap- 
plied to the teeth by rubbing it upon them with a soft 
sponge on retiring at night. In the morning it should 
be rinsed from the mouth before the brush is used. 
It can readily be prepared by taking a clean, well- 
charred piece of wood charcoal, and powdering it very 
finely in a mortar. 

Another pleasant and excellent powder is the fol- 
lowing: — 



Take of— 

Sugar of milk, two ounce;,. 

Tannic acid, a quarter ounce. 

Red lake, a half drachm. 

Oil of anise-seed, five drops. Mix carefully. 
Use every morning. 



The teeth should not be used to crack nuts, cut 
thread, etc, as many persons do -use them, but they 
might with advantage be employed in chewing the 
food more thoroughly than most fast eaters do. 

When decayed, it is economy in the end, as well as 



130 CLOTHING AND THE TOILET. 

comfort, to have them promptly filled by an expert 
dentist; and when quite gone, to replace them with 
an artificial set, for those who attempt to continue 
with decayed teeth or toothless gums will soon find 
their digestive powers give way, because the food has 
not been sufficiently masticated. 



CARE OF THE HAIR. 

There is a national tendency in this country to 
early loss of the hair. Sometimes this arises from im- 
pairment of the general health, for it is constantly ob- 
served that certain general diseases are accompanied 
by falling out of the hair. In such cases, local 
applications of any kind will be of no avail until the 
general trouble is removed. 

Sometimes the cause is a disease of the skin of the 
scalp, which demands specific local treatment, the 
same as diseases of the skin on any part of the body; 
the consideration of this condition we will leave until 
we come to that part of our work which treats of skin 
diseases, and confine ourselves now to the care of the 
hair with a view to the prevention of disease and 
baldness. 

Cleanliness is of the first importance. It should be 
secured not merely by brushing and combing, but by 
washing the scalp thoroughly with soap and warm 
water every week or two. The brush should be stiff, 
and reach the skin of the head. But the comb is 
designed chiefly for arranging the hair. 

The ends of the hair should be carefully trimmed 



HOW TO SAYE THE HAIR. 131 

about once a month. Very little need be taken off at 
a time, and if it is desired to maintain the hair long, 
only the twisted and dead extremities need be re- 
moved. This is a tedious occupation, but one which 
greatly increases the vigor and beauty of the growth. 

In reference to tonics, washes, and oils, there is a 
great variety which have been urged upon public 
notice of late years, and several large fortunes have 
been accumulated from their sale. Usually these 
nostrums are of inferior and sometimes of poisonous 
ingredients. They should be shunned, and prepara- 
tions of known composition, as good -if not better 
than these, and costing but a third of their price, be 
used in their stead. We shall give a number of 
receipts for such. 

For falling or loosening of the hair: — 




Take of— 

Whiskey, one wineglassful. 

Glycerine, one tablespoonful. 

Quinine, twenty grains. 

Water, a half pint. Mix. 
Rub on the scalp every morning. 




Anc 


)ther for the same trouble: — 






Take of— 

Castor oil, 

Alcohol, each one ounce. 

Spirits of ammonia, a half ounce. 

Rose-water, one pint. Mix well. 
Rub the head every morning. 








i 



132 


CLOTHING AND THE TOILET. 






Take of— 

Alcohol, a half pint. 
Salt, as much as will dissolve. 
Glycerine, a tablespoonful. 
Flour of sulphur, a teaspoonful. Mix. 
Rub on the scalp every morning. 


V 


The 


following is also an efficient hair tonic :— 






Take of— 

Tincture of cantharides, one ounce. 
Glycerine, a half ounce. 
Oil of bergamot, twenty drops. 
Water, a half pint. Mix. 
Use as above. 




Grayness of the hair occurs in different people at 
very various ages. In some it appears in youth, and 
at middle age they have the silvery lines thickly 
scattered over their heads. Others, again, retain the 
natural color of both hair and beard to a very ad- 
vanced age. This does not seem to have any refer- 
ence to strength of constitution or of the hair itself. 

It is a familiar fact, however, that anxiety, fright, 
grief, and terror blanch the hair with great rapidity, 
even causing a very perceptible change in the ^paee of 
a very few hours. 

There are no known means by which the hair can 
be prevented from turning gray, and none which can 
restore it to its original hue, except through the 
process of dyeing. The numerous "hair color re- 
storers" which are advertised are chemical prepara- 
tions which act in the manner of a dye or as a paint, 
and are nearly always dependent for their power on 



BENEFITS OF WASHING. 133 

the presence of lead. This mineral, applied to the skin 
for a long time, will lead to the most disastrous mala- 
dies — lead-palsy, lead-colic, and other symptoms of 
poisoning. It should, therefore, never be used for this 
purpose. 

The following preparation will gradually darken 
the hair, and has no bad effects : — 



Take of— g 

Blue vitriol (powdered), one drachm. 

Alcohol, one ounce. 

Essence of roses, ten drops. 

Rain-water, a half pint. 
Shake together until they are thoroughly dissolved. 



CARE OF THE SKIN. 

The skin requires little special attention to preserve 
it in a healthy condition, beyond keeping it clean. 
This should be done by regular bathing and rubbing 
with a coarse towel or flesh-brush until a pink hue is 
produced. 

The importance of attention to the skin will be 
readily understood, when it is considered that it is 
one of the most important avenues through which 
worn-out materials are discharged from the system. 
Unless it is maintained in a wholesome condition, the 
internal organs are over-worked and clogged, and the 
general health is impaired. 

The bath should be taken daily in cool or tepid 
water, and the body be thoroughly dried. Soap should 
be employed at least once a week. The shower-bath 



134 CLOTHING AND THE TOILET. 

is only adapted for persons of a vigorous constitution, 
as on others it produces too great a shock. 

When the skin is liable to crack and chap after 
bathing, a tablespoonful of glycerine added to the 
water will usually prevent it. 

"When the conveniences of a bath-tub or similar 
appliance are not at hand, a large sponge can be used 
with which the body can be rubbed down. In some 
manner, daily bathing should be practised, as it is 
justly regarded as one of the most effectual preserva- 
tives known against disease of all kinds. 






CHAPTER V. 

ON HEALTHY DWELLING-HOUSES. 

CONTENTS. 

The choice of a building site — Building material — The cellar — The upper 
stories — Drainage and waste products — Light and means of lighting — Arti- 
ficial light — Dangerous oils — Effect of artificial light on air — The ventila- 
tion of dwellings — Means of warming — Paper-hangings — Furnishing a 
house — The kitchen and its furnishing — Newly -built houses — Old houses. 

If Italian proverb says that the man who has 
not built a house, written a book, planted a 
tree, and begotten a child, has not fulfilled his whole 
duty to his race. But he who builds a house without 
haying a due regard to the laws of health in its con- 
struction is much more to blame than he who leaves 
that obligation altogether unfulfilled. For certain it 
is that a large percentage of sickness arises directly 
from ill-constructed dwellings. 

To enter at length into the hygienic considerations 
to be regarded in building or buying a residence 
would require an amount of space and a minuteness 
of detail which we cannot spare in this connection. 
But the chief and vital points ought to be familiar to 
every head of a family, and our object of instructing 
how to prevent disease would be but partially accom- 

(135 ) 



136 ON HEALTHY DWELLING-HOUSES. 

plished, were we to neglect giving somewhat full 
instruction on this exceedingly practical point. 
"We shall first call attention to 



THE CHOICE OF A BUILDING- SITE. 

Those who have the choice of a place of abode, and 
who seek health above other things, should live in the 
country. If inclination or necessity lead them to the 
city, they should select a dwelling in a cheerful, open, 
elevated suburb ; or in a wide street and near a square. 

In selecting a site, the natural drainage must be 
remembered. And here a knowledge of the texture 
and stratification of the underlying rocks is impor- 
tant. Clay is less healthy than porous, gravelly soils. 
A damp soil is one of the most common causes of 
consumption, bronchitis, and similar complaints. It 
also gives rise to attacks of rheumatism. Dry im- 
permeable soils are the most healthy; next to these, 
dry soils which allow ready passage to the water. 

The elevation is of very considerable moment. 
Low-lying situations, especially those along river- 
bottoms and near their mouths, are, as a rule, un- 
healthy, and persons living in them are more liable to 
the attacks of epidemic diseases. During the visits 
of cholera to our great cities, it was quite constantly 
observed that the number of deaths steadily diminished 
as the height of the ground increased. Consumption 
is asserted by some writers never to originate above 
a certain height above the level of the sea. As a 
general rule, low-lying places are colder than the 



WHAT TO BUILD OF. 137 

neighboring hill-tops in winter, and hotter in summer. 
They are peculiarly liable to fogs, and suffer first 
from the autumnal frosts. 

A prudent builder will avoid choosing made ground. 
This has usually been filled in from the refuse of 
empty lots, dust-bins, and cellars. There is no doubt 
but that its effects on the health are deleterious. 
Certain maladies, like scarlet fever and typhoid, are 
more dangerous and obstinate in houses built on 
made ground. The slowly decaying accumulations 
of organic matter it contains must tend to undermine 
the health. 

BUILDING MATERIAL. 

"Wood, brick, and stone are the chief materials used 
in the construction of dwellings in this country. The 
decision as to which should be selected is not without 
hygienic interest. Stone houses are notoriously 
damper than those which are frame or brick. Their 
walls are given to " sweating," that is, the atmospheric 
moisture condenses upon them and trickles down, pro- 
ducing dampness and mouldiness. Serpentine stone, 
which is a better conductor than other varieties, is 
free from this objection. 

Frame houses are liable to early decay, and to con- 
flagration, and are not always so easily warmed as 
others. In many cities their construction is for- 
bidden. 

Neither material combines so many advantages, 
and is so free from disadvantages, as brick. It 
answers all the purposes of a cheap, sanitary, and 



138 ON HEALTHY DWELLING-HOUSES. 

abundant article for the construction of residences. 
And where no especial fitness decides for stone or 
wood, it is usually preferred. 



THE CELLAR. 

Every house should have a cellar, which should 
extend under every one of the ground floors. There 
is no economy and there is imprudence in laying 
joists directly upon the soil or immediately over it. 
Even bedding them in mortar is an inadequate step. 

"We have repeatedly known families to suffer year 
after year from low fevers, from no other cause than 
the exhalations from beneath their kitchen floors. 

The cellar should be not less than seven feet high, 
with windows on each side which open to the air. 

The windows should be one-third above the level 
of the ground, and so constructed as to be easily 
opened. 

The cellar floor should be of mortar containing 
plenty of lime, or, still better, of cement, and the walls 
should be either plastered or cemented. The ceiling 
should be " rendered," that is, it should be plastered 
between the joists. These precautions, though seem- 
ingly minute, are by no means superfluous. It has 
again and again been demonstrated that typhoid and 
typhus fevers have proceeded directly from emana- 
tions of the soil or the sewers entering the cellar, and 
thus gaining admittance through the house. The 
entrance of water to the cellar is a frequent cause of 



THE LOCATION OF ROOMS. 139 

sickness, and must be prevented. No old well or 
dirt-receptacle should be allowed. 

As the cellar is the usual storehouse for roots and 
vegetables, it should have bins appropriately fitted up 
for keeping them, and the housekeeper cannot be too 
solicitous in preventing the accumulation of decaying 
materials of any description. Several large lumps of 
fresh-burnt quicklime should be laid on the floor, so as 
to absorb the moisture and purify the atmosphere. 

THE UPPER STORIES. 

In the better class of dwellings in England and on 
the continent of Europe the basement or ground floor 
is not occupied by the family, but is used for the 
kitchen, storerooms, pantry, and dining-rooms. This 
is a prudent measure in a damp climate, as the first 
floor is the coldest and dampest in the house, and the 
most exposed to impure exhalations from the cellar 
and neighboring soil. 

Houses with what builders call an " English base- 
ment," that is, with the first story low and but slightly 
raised above the ground, are becoming quite popular 
in our cities, and when the rooms above are exclu- 
sively adopted for sleeping and sitting purposes, they 
are to be preferred in crowded localities. 

Many French dwellings have a still lower story above 
the basement, called the entre sol, usually assigned to 
the servants, etc., so that the family themselves occupy 
chiefly what we would call the third floor. They gain 
by this arrangement greater privacy and better air. 



140 ON HEALTHY DWELLING-HOUSES. 

Bedrooms should not be chosen on the first floor of 
any house, and preferably the third floor should be 
selected. This is no less true of country than of city 
houses. 

The height of each story should be at least nine feet 
in the clear, and range from this to twelve or fourteen. 
The purity of the air is greatly facilitated by a mode- 
rately lofty ceiling; but beyond the height last men- 
tioned there is no advantage on this score, and there 
is a positive drawback in the difficulty of maintaining 
an equable temperature in winter. 

Every house should have a garret or attic, with 
several windows, and extending over the whole of the 
upper story. The summer heats are then much less 
felt in the inhabited portions of the house, and the 
ventilation of the halls and stairways is improved by 
such an arrangement. 

Inventors have exhausted their ingenuity of late 
years in devising roofing materials of various kinds, 
but, in point of health, nothing has been discovered 
superior to cedar shingles well laid. They exclude 
the rain, are warm in winter and cool in summer. 
Slate roofs, on the contrary, by absorbing the heat, 
greatly increase the temperature in hot weather, and 
decrease it in the cold season. 

"While we are on the roof of our house, we will natu- 
rally look to see that a lightning-rod rises above it 
sufficiently high to protect it against the electric dis- 
charges, and that it is well insulated by means of glass 
or horn rings as it passes down the wall. The simple 
rule is that a rod protects the area of a circle the 



SEWERS AND SINKS. 141 

radius of which is four times the height of the rod 
above the roof. 



DRAINAGE AND WASTE PRODUCTS. 

The researches of sanitary officers have conclusively 
shown that no cause of disease is more to be feared 
and provided against than the accumulation of waste 
products of various kinds in and near habitations. 
By these products we mean slops, garbage, dishwater, 
the contents of privies, sinks and sewers, dust, bones, 
etc. etc. 

The high mortality in low-lying districts is to a 
great extent owing to the difficulty in removing these 
accumulations. No house can be healthy unless pro- 
visions are made for preventing vapors and gases 
being discharged from them into the atmosphere of or 
around it. 

In towns the simplest and easiest way is to convey 
the more objectionable portion of the refuse into sewers 
by the action of water. The main sewer should never 
run under the house, for, should it happen to leak, sad 
results to health would probably ensue. Sewer-pipes 
should have a fall of at least two feet per hundred 
feet, and should be "flushed" from time to time by a 
full stream of water. 

The water-closets should always be maintained in 
perfect order, and no pains spared to prevent bad odors 
or the escape of gas from them. 

The "earth closet," which we shall describe in a 
later chapter, is well adapted for towns, villages, 



142 ON" HEALTHY DWELLING-HOUSES. 

country houses, and public buildings. But in cities 
with abundant water-supply it is not likely to super- 
sede the more convenient water-closet. 

The yard of a farm-house in this country often 
presents a large, unsightly, and foul-smelling cesspool, 
not far from the kitchen door, into which the waste 
water runs. Proprietors would consult both health 
and appearance by conveying the refuse in a covered 
drain to a distance of fifty or sixty yards from the 
house. 

The more solid portions of refuse are, or should be, 
in cities carted away from the immediate neighbor- 
hood of the houses, and in country places should be 
used to make compost heaps for fertilizing. 

Private sinks or cesspools in cities should be 
prohibited. Such action has already been taken in 
several of our large cities, and should be general. 
Their deadly vapors cannot fail to taint the atmosphere 
for yards around. Their overflow or leakage cannot 
be prevented; and their abolition has uniformly been 
attended with improvement of the general health. 

On the other hand, the pollution of rivers by town 
sewage has become an evil of magnitude, and demands 
a remedy. One of the problems of the day is the 
"utilization of sewage." In London and elsewhere 
earnest attempts have been made to collect the various 
refuse products and the contents of the sewers, and 
employ them in the manufacture of artificial manures. 
These projects have met with partial success, but have 
not yet been so successful as to have been generally 
adopted. 



THE IMPORTANCE OE WINDOWS. 143 

LIGHT AND THE MEANS OF LIGHTING. 

The ancient saying that "light is life" is abundantly 
confirmed by modern science. Nothing is better 
established than that this agent is essential to full 
health. The pale, flabby, and bloodless face of the 
inhabitant of a dark cell or a gloomy chamber contrasts 
painfully with the ruddy glow and firm flesh of the 
countryman who lives in the open air and the light of 
the sun. 

We have to consider both the means of natural and 
artificial lighting when we examine a house. 

In the first place, there should be no dark, window- 
less rooms in it. We have seen dwellings called "first 
class," with handsome stone fronts and carved steps, 
which contained chambers without a window ! Such 
houses are dear at any price. Every room should give 
admittance to the sun at some hour of the day. "Shut 
the door to the sun, and you will open it to the 
doctor," say the Italians. "Sunlight," says Sir David 
Brewster, "is the life-blood of nature; without it, 
everything material would fade and perish." 

"It is a personal duty," says this same philosopher, 
"to construct our dwelling-houses upon such principles 
and in such styles of architecture as will allow the 
sunlight to have the fullest and freest entrance, and 
to chase from every crypt, cell, and corner the elements 
of uncleanness and corruption which have a vested 
interest in darkness." 

The practical application of this principle is to see 
that every room has one or two good-sized windows 



144 



ON HEALTHY DWELLING-HOUSES. 



from which the open sky can be seen and the sun's 
rays admitted. Houses which face the east or south- 
east haye the best aspect, because in the morning the 
sun's rays penetrate to the front rooms, and in the 
evening the back apartments are exposed to its cheer- 
ful and vivifying influence. The front rooms of a 
house facing the south are in summer ever warmed by 
the direct rays of the sun, while the back rooms 
receive no share of direct light. 

While we fully appreciate the beauty and comfort 
of a shady lawn, and shall have something to say of 
the hygienic value of trees hereafter, yet we are not in 
favor of having large trees with dense foliage close to 
a house. They keep its walls damp, harbor many 
insects, and shut out the light. 

A French physician has given a striking illustration 
of the injury which shade-trees sometimes cause. On 
one occasion his attention was attracted by the obvi- 
ously wanton mutilation of several large mulberry- 
trees, the branches of which had heavily shaded a 
school-room in which a number of girls received their 
education. On asking the reason for such destruction, 
he was informed that previously to the removal of the 
branches the gloom and dampness had visibly im- 
paired the health of the scholars; while since they 
had been lopped away, a very favorable change had 
taken place in the condition of the girls, which could 
only be attributed to their exposure to the unimpaired 
light of the sun. 

The sick do not recover so quickly in dark rooms 
as in those where direct light gains admittance. The 



HOW TO LIGHT A TOWN" OFFICE. 145 

dark sides of streets are more frequently visited by 
the physician; and the northern wards of hospitals 
present more lingering cases than others. 

In crowded cities, where narrow streets and high 
walls shut out the* rays of the sun, there are many 
expedients resorted to, to increase the light in work- 
rooms, counting-houses, and offices. Metallic reflectors 
are often seen outside the windows, and often the gas 
must be lighted long before the sun goes down. 

A simple architectural expedient will do away with 
the need of reflectors, and will illuminate the whole 
room as long as the day lasts. It is this : in place of 
the ordinary window-sash, which is always placed at 
a distance of three to six inches from the outer surface 
of the wall, and often still deeper, we substitute 
another in which all the panes of glass are roughly 
ground on the outside, and flush with the outer wall. 
By this simple means the light from the whole of the 
visible sky, and that reflected from the remotest parts 
of the opposite walls, will be introduced into the apart- 
ment, reflected from the innumerable faces or facets 
which the rough grinding of the glass has produced. 
The whole window will appear as if the light were 
beyond it, and from every point of this luminous sur- 
face light will radiate into all parts of the room. 

This excellent suggestion, which we owe to the 
scientific mind of Sir David Brewster, should be 
adopted in the construction of all town offices where 
there is want of illumination. 



10 



146 ON HEALTHY DWELLING-HOUSES. 

ARTIFICIAL LIGHT 

In cities is now almost exclusively obtained by means 
of " coal gas." This, as every one knows, is made by 
heating mineral coal in retorts. It is a complex chemi- 
cal product. 

So long as there is no leak in the pipes, and care is 
taken to prevent the escape of the gas, it is an un- 
objectionable means of producing light. But cases 
have frequently occurred in which death has resulted 
from an escape of gas into sleeping apartments. 
This result is owing to the presence of carbonic oxide 
gas or other impurities. 

All coal gas is purified before being passed into the 
receiver, and various methods are employed to accom- 
plish this, not all of equal efficacy. That which is 
most highly recommended, and which would appear 
to deserve to come into general use, is by means of 
oxide of iron. 



KEROSENE AND DANGEROUS OILS. 

In country localities the principal sources of artificial 
light are some of the products of petroleum, variously 
known as kerosene, mineral, lamp oil, etc. These can 
and ought to be rendered truly non-explosive, and as 
safe as the whale oil used by our fathers ; but as this 
requires an additional refinement at a cost of a few 
cents a gallon, unworthy competition and the unscru- 
pulous cupidity of venders push into the market large 
quantities of kerosene as inflammable and as danger- 



THE DANGERS OE KEROSENE. 147 

ous as so many barrels of gunpowder. Hardly a day 
passes that accidents are not recorded from its explo- 
sions, with destruction of life and property, and it is 
estimated that more than two thousand persons are 
killed or injured annually by these accidents. 

Many States have passed laws regulating the sale 
of this oil, providing tests for its examination, and 
stringent penalties for offering that which is dangerous. 
But there is a prevailing negligence in carrying these 
into effect. 

Many of the oils advertised as "Safety" and "Non- 
explosive" are in fact of the most perilous character. 
Unfortunately, the testing of the oil to ascertain its 
character is not easy, and can only be successfully 
carried out by an experienced person. 

It is to be borne in mind that it is only the vapor 
w T hich arises from the surface of the liquids, mixed with 
air, which suddenly explodes. A lamp or can cannot 
explode if full or nearly so. Dealers often hold a 
lighted match to the oils they sell, set fire to them, 
handle them, and pretend to prove in this way that 
they are not dangerous. 

This kind of experimenting is unfortunately deemed 
satisfactory by many, and they readily purchase the 
dreadful combustible for their families. Now, the 
fact that these men are able to ignite their fluids so 
readily is positive proof of their dangerous character; 
for any liquid, so volatile as to take fire at ordinary 
temperatures, will supply vapor in lamps and cans 
which, when mixed with air, will explode like gun- 
powder. 



148 ON HEALTHY DWELLING-HOUSES. 

But it is not often that the conditions are favorable 
in lamps and cans for explosions, and they do not often 
occnr. Three-fourths of all the accidents which are 
reported as lamp explosions are not explosions ; they 
are horrible burnings from the simple ignition of the 
fluid from spilling it upon the clothing, or by the 
breaking or upsetting of lamps. These naphtha 
fluids are not so dangerous from the liability of the 
vapor to explode, as from the inflammability of the 
liquids themselves. The loss of life, and the loss to 
insurance companies from the burning of buildings, 
are due much oftener to the ignition of the fluid than 
to explosions; occasionally a genuine lamp explosion 
occurs, but not often, for it is difficult to have in a 
lamp or can just the right mixture of air and vapor. 

It is not necessary for purchasers and dealers to be 
put to the trouble of experiment. They should know 
that any liquid which will burn readily at ordinary 
temperatures is unsafe. Nothing can he added to gaso- 
line or naphtha ivhich will render it safe, or the vapor 
unexplosive. The travelling quacks do not add any- 
thing to their liquids but cheap insoluble substances, 
and this they do to keep up the deception. 

"When any one comes before officers of insurance 
companies, dealers, or consumers, claiming that he 
has an "inexplosive oil," which is "perfectly safe," and 
challenges a trial, let them turn a little of the fluid 
into a cup or saucer, and if it takes fire when touched 
with a match, it certainly will afford explosive vapors, 
and is a dangerous agent 'The venders of such fluids 
are conspirators against the lives and property of 



A RAPID CONSUMER OF AIE. 149 

consumers, and they should at once be arrested and 
turned over to the prosecuting officers of the common- 
wealth. 

EFFECT OF ARTIFICIAL LIGHT OX AIR. 

The effect produced on the air of a room by the 
combustion incident to artificial light is nearly the 
same as when a number of persons are breathing in 
it. One pound weight of oil consumes about 140 
cubic feet of air, while the quantity breathed by an 
adult man is on the average 16^ cubic feet per hour. 

Every cubic foot of coal gas uses up the oxygen of 
from 14 to 15 cubic feet of air. An ordinary gas- 
burner consumes nearly 45 cubic feet of air per hour, 
and, therefore, vitiates the atmosphere of a room to 
an extent nearly equal to that produced by the respi- 
ration of three men. Nevertheless, a good article of 
coal gas, in giving as much light, evolves but one- 
fourth the amount of carbonic acid gas which results 
from the combustion of tallow candles. Large gas- 
burners give more light, in proportion to the quantity 
of gas consumed, than small burners do. . 

THE VENTILATION OF DWELLINGS. 

Few questions of public hygiene have been more 
prominently brought before the public than that of 
ventilation, especially as applied to churches, court- 
rooms, legislative chambers, and other public struc- 
tures. 



150 ON HEALTHY DWELLING-HOUSES. 

The object is to obtain a change of air at the rate 
of two thousand cubic feet per hour for each person. 
^Numerous plans and not a few discrepant propositions 
have been advanced to accomplish this. "With such 
discussions we shall have nothing to do, but confine 
ourselves to the practical question, in which every 
individual is interested, how to secure the best venti- 
lation in ordinary dwelling-houses ? 

We may consider this question to be proposed 
under two different circumstances: the one, when a 
person is planning a residence, and desires to look to 
means of ventilation in its construction; the other, 
when the house is already built without them, and the 
object is to devise the most efficient substitutes. 

Careful experiments of recent date have overthrown 
the old idea, founded on theoretical considerations, 
that the vitiated air should be allowed a place of 
escape at the highest point of the apartment, near the 
ceiling. Just the reverse of this is true. The opening 
into the ventilating flue should be near the floor, and 
in order to secure an ascending current of air the flue 
must be warmed. This can be done in several 
manners. "When large, we have known a gas-jet to 
be placed in them. But a cheaper and better plan is 
to place them close to the chimneys. 

As has been remarked by Dr. S. H. Douglass: 
"The plan of base ventilation is the system that most 
commends itself to our practice. Double flues, one 
for the conveyance of smoke and the products of com- 
bustion, the other the foul air of our rooms, placed 
when practicable in the interior of our dwellings, and 



HOW TO VENTILATE A ROOM. 151 

having ventilating registers opening at or near the 
floor, if of sufficient capacity, will secure the required 
purity of air." 

The advantages of this plan are not only evident by 
a study of the theory of impure air, but have been 
strikingly exemplified by repeated experiments in 
hospitals and private dwellings in Philadelphia and 
other cities. The architect of a house should not 
omit to embrace such ventilators in his plans. And 
when they are neglected, they should be insisted upon. 

The old-fashioned open fireplace acted precisely on 
this principle, and formed one of the best ventilators 
which could be devised. It deserves to be retained 
for this if for no other reason. 

A ventilator near the ceiling also aids in removing 
foul air, but to a less degree, and only after it has 
done most of the harm which we seek to avoid. 

The second case supposed, is where we have to 
devise some plan to supply fresh air in chambers in the 
walls of which no ventilators have been constructed. 

Obviously our first recourse is to the windows. 
These should be freely opened whenever the weather 
permits. Bad air is often more pernicious than a 
"draft." When the upper sash lowers, a crack of 
two inches will secure quite an active atmospheric 
current. 

A still more satisfactory plan, when the weather is 
cold or one is sensitive to a draft, is to place a piece 
of board an inch or two in thickness, and in length 
equalling the width of the sash, immediately below the 
lower sash, so as to prevent it lowering to the frame. 



152 ON HEALTHY DWELLING-HOUSES. 

This throws the upper edge of the lower sash above 
the lower edge of the upper one, thus leaving a crack 
through which the outer air rushes, not directly into 
the room, as when the sash is opened, but from below 
upwards. There is no draft perceived, while yet a 
large amount of fresh air is introduced. 

Next to the window, the door offers a means of ven- 
tilation. Sleeping chambers should as a rule have a 
transom over the door, with a revolving window. Or 
the upper panel of the door may be cut out and placed 
upon a hinge. The habit of listing doors, though 
favoring warmth, shuts out the air. Door-sills to 
chambers are undesirable, and are no longer put in the 
best residences. 

As a last resort, we can break a hole in the wall and 
insert a tin or iron tube, one end of which shall be 
directly over a gas-light, and the other in the open air. 
This works well, but is not always free from down 
drafts. 

The pertinent inquiry may be made, whether air 
vitiated by respiration and combustion cannot be 
promptly purified, instead of being expelled and its 
place supplied by that which is fresh. Could this be 
perfectly accomplished, we need trouble ourselves no 
further about ventilation. 

Hygienic chemistry can do much, but it cannot yet 
do this. Nevertheless, where abundant ventilation is 
impossible, much of the poison which contaminates 
the air can be neutralized by the judicious and abun- 
dant use of those articles known as disinfectants. In 
a later chapter we will mention several of these, which 



HOW TO WARM A ROOM. 153 

may with advantage be kept in crowded rooms and 
shops. 

MEAN'S OF WARMING. 

The days of the fire on the hearth, with its back-log 
and fire-stick, its dancing flames and heaps of glowing 
embers, have almost passed away. Only in remote 
country hamlets and retired farm-houses do we now 
and then greet once more this familiar memory of our 
boyhood. Now even the owners of acres of woodland 
buy and burn coal, and in cities a wood fire even in a 
stove is a rarity. 

"Warming flues extending through the house from a 
furnace in the cellar are the ordinary heating apparatus 
of an American house. It is a convenient and health- 
ful plan, provided that certain precautions are taken. 

The first is to obtain the proper kinds of furnace. 
Of course we have no intention of recommending any 
particular article, but some of the plans adopted for 
heating the air are objectionable. When the cold air 
is warmed by passing over heated plates of cast iron, 
the air is over-dried and carbonic oxide gas is de- 
veloped, which is poisonous in character. The sur- 
prising fact that various gases pass through the solid 
substance of several metals when heated to dull red- 
ness has only recently been ascertained, and has a 
most important bearing on house-warming. Those 
furnaces in which the air is heated by circulating be- 
tween drums of rolled sheet-iron, at a temperature 
considerably below redness, are much the best. 

Those furnaces in which the air is heated by passing 



154 ON HEALTHY DWELLING-HOUSES. 

among coils of pipe filled with hot water are on this 
account to be preferred. 

Proper precautions must also be taken to insure a 
full supply of fresh air. In most furnaces the air 
which passes into the flues enters the chamber of the 
furnace directly from the cellar, and carries with it to 
all parts of the house the impurities with which it is 
loaded. Many cases of illness are thus caused. To 
remedy this, the pure air should be conducted from 
outside the cellar through a large wooden or tin tube 
to the furnace-chamber. When this is not practi- 
cable, the cellar should be maintained in scrupulous 
cleanliness, and the utmost care taken that emana- 
tions from sinks, sewers, or cesspools do not gain 
admittance to it. 

Air when heated becomes dryer, that is, its capacity 
to absorb moisture is increased. As this is considered 
objectionable, a well-known maxim in domestic hy- 
giene is to place a vessel of water on the stove or in 
the furnace-chamber. Such a measure is not objec- 
tionable, but it is of much less importance than many 
precautions constantly neglected. Economically it is 
advantageous, because in a warm atmosphere which is 
moist we feel warmer than at the same temperature in 
a dry air. On the other hand, a dry heat is bracing, 
while moist and warm air is debilitating and relaxing 
in its action, at the same time that it depresses the 
nervous system. The human body itself gives off 
about a quart of water a day from the lungs and skin, 
so that it adds materially to the moisture. 

Stoves are less healthful than well-constructed 



THE DAGGERS OF CAST-IRON STOVES. 155 

furnaces, because they always allow the escape into 
the apartment of a portion of the unhealthy gases 
generated during combustion, and also volatilize any 
organic matters which come in contact with them. 
Cast-iron stoves are a not unfrequent cause of typhoid 
fever, the gases passing through the plates when 
heated. 

Hot water or steam conveyed in pipes through the 
house affords an excellent means of warming. This 
method is, however, expensive, and more likely to be 
chosen for public than private dwellings. 

REGULATION OF TEMPERATURE. 

Whatever method of heating is adopted, it is of the 
utmost importance to know how to regulate the 
temperature. It is astonishing to what a degree we 
are creatures of habit in this respect, and how readily 
we become habituated to a much higher temperature 
than is necessary or beneficial for us. Dr. Chambers 
relates an instance, and that, too, of a medical man, 
who, being sensitive to cold, instead of inuring him- 
self to it, constantly added to his clothing. He wore 
double flannel, made expressly for his private use, all 
over his body even in the warm season ; he always 
had a fire in his bedroom and slept under heaps of 
clothes ; but, in spite of all this coddling, he not only 
suffered more and more from chilliness, but became 
a wretched dyspeptic. 

Now what was Dr. Chambers's treatment? He 
advised him at once, although in February, to throw 



156 ON HEALTHY DWELLING-HOUSES. 

off his extra clothing, to take a cold shower-bath 
every day, and active movements in the open air. 
This was the correct treatment, and soon all the 
distressing sensations disappeared. 

"We constantly find "tender" people who keep their 
living-rooms at a temperature of nearly 80 degrees in 
winter, and to our remonstrances assert that they are 
" chilly" if the air is cooler. This is foolish " coddling," 
and if they would take a cold bath every day, and a 
brisk walk in the out-door air without too many wraps, 
they would suffer far less from the cold. 

A thermometer should be in every sitting-room, 
and it should not be permitted to indicate a tempera- 
ture of more than 70 degrees. This is always warm 
enough, and any greater heat is actually hurtful. Dr. 
Kane in his expedition to the Arctic regions found 
that the men were more comfortable when the cabin 
was at 60 or 62 degrees than when it was hotter; and 
this is about the temperature recommended for hos- 
pital wards. 

Persons should know that "colds" are as often 
caught by going suddenly from a cold to an over- 
heated atmosphere — as from the street on a cold 
winter day into a room at 80 degrees — as from a 
heated room into the cold. The less the change, the 
greater the safety. 

PAPER-HANGINGS. 

The importance of first-class plumbing in a house 
cannot be overrated. In a previous chapter, where 



GREEK WALL-PAPERS INJURIOUS. 157 

we spoke of the impurities of water, we gave a suffi- 
cient number of hints in reference to the care to be 
exercised in distributing that fluid in dwellings. "We 
propose now to direct attention to an obscure but 
frequent cause of reduced health, which is too much 
overlooked, but which every house-buyer and house- 
builder should be acquainted with.; this is, the 
poisonous character of some colors of paper-hangings. 

These are those which have been colored with 
arsenical dyes. Nearly or quite every green wall- 
paper contains arsenic, and is therefore injurious to 
the health. The light greens are no safer than the 
dark ones, for the very palest contain large quantities 
of arsenite of copper, the brilliant color of which is 
toned down by the addition of chalk or white-lead. 
Chemical analysis proves that sometimes from five to 
fifteen grains of this poisonous substance are contained 
in one square foot of paper. 

As the arsenic is exceedingly volatile, it quickly 
passes into the atmosphere of the room, and is inhaled 
by the breath in the form of a fine, impalpable dust, 
producing numerous symptoms of diseases, the true 
cause of which continues wholly unsuspected by both 
physician and patient. All persons should make it a 
rule to refuse to purchase green wall-papers, and not 
to sleep or work in close rooms where this color is 
upon the walls. 

Some of the symptoms produced by this slow form 
of poisoning may be mentioned here, so that they may 
impress the point we make still more forcibly. 

First appears irritation of the mucous membrane, 



158 OK HEALTHY DWELLING-HOUSES. 

causing diarrhoea and vomiting, with various other 
symptoms of severe derangement of the stomach, re- 
sulting in permanent indigestion : also incessant severe 
cold in the head, which, in one instance, lasted for 
several years without being touched by any remedy; 
ulcerated throats, with acute inflammation, resembling 
diphtheria and quinsy; severe spasmodic cough, spas- 
modic asthma, bronchitis, and congestion of the 
lungs ; soreness of the mouth, lips, and tongue, which 
appear as if scalded in patches; inflammation of the 
eyes and eyelids (the conjunctivae being invariably 
bright red), in one case threatening absolute loss of 
sight ; congestion and torpidity of the liver, with the 
various symptoms resulting therefrom; and severe 
bilious and feverish attacks. There is, in short, irrita- 
tion of every organ. In many cases, if not in all, the 
action of the heart is weakened, and in some palpita- 
tion frequently occurs. There are pains in various 
parts of the body, especially across the shoulders, 
down the spine and limbs, also in the joints, which are 
often stiff and swollen; scaling of the skin, and irri- 
tating eruptions. The effects upon the nervous system 
are most remarkable, producing a thoroughly shattered 
condition; great irritability, depression, and tendency 
to tears ; with unusual prostration of strength. These 
latter symptoms are especially marked in children. 

A wall in hard finish, painted or frescoed, is far pre- 
ferable to one in paper, and, so far as health is con- 
cerned, a whitewashed wall is better than either. 

A second observation with reference to paper-hang- 
ings is that when they mould upon the wall, they 



THE CAUSE OF A PUZZLING- OFFENSIVE SMELL. 159 

undoubtedly vitiate the air of the apartment. On 
eastern exposures and in stone houses it will some- 
times be noticed on stripping a small piece of the 
paper from the wall, that the latter is covered with a 
gray or green mould, haying a faint, nauseous odor. 
"When this is the case, the whole of the paper should 
be removed, and the wall either " stripped' 9 and plas- 
tered, or else finished in hard finish and left unpapered. 
Every dictate of prudence also reprehends the filthy 
custom among people of pasting one wall-paper over 
another, till a thickness of an eighth of an inch or more 
has accumulated. This was the cause of the puzzling 
offensive smell at a soldiers' barracks in London, that 
a year or two ago threatened the whole establishment 
with fever. The examination of the drains and taking; 
up of the floors revealed nothing, while the introduc- 
tion of increased means of ventilation left the evil as 
it was. At last an examination was made of the wall- 
papering, when it was found that one paper was pasted 
over another till a thickness was accumulated amount- 
ing in one case to fourteen layers. Between these 
layers there was rotten paste, in which fungi and even 
worms germinated, the stench spreading over the 
establishment. 

FTTRXTSHTN-G-. A HOUSE. 

A rigid hygienist would be an economical house- 
furnisher. Velvet-like carpets, downy pillows, soft 
upholstery, and carved wood-work would not meet his 
approval. 



160 OlST HEALTHY DWELLING-HOUSES. 

He is aware that the most subtle poisons in the 
atmosphere are the organic matters which are thrown 
off from our own bodies ; and he knows that these are 
retained in dwelling-rooms chiefly by the carpets, the 
upholstery, the curtains and hangings. Even the 
solid parts of the furniture, the paper on the walls, 
and the ornamental work of the wood-carver, offer 
opportunities for the accumulation of these pestiferous 
materials. 

Carpets gratify the eye, but a painted or polished 
floor, or one covered with oil-cloth, is more salubrious. 
Sofas and stuffed seats indulge the sense of luxury, 
but lay traps for the health. 

Modern furniture is, however, an improvement on 
that which was in fashion fifty years ago. The furni- 
ture of that day was massive and encumbered with 
upholstery. The bed was surrounded with heavy 
curtains and covered with a canopy. It was often 
placed in a recess, or in a small cabinet leading into 
the main chamber. 

Now there is some provision for a freer circulation 
of air. The wood- work is lighter and less absorbent ; 
curtains are out of date ; spring, hair, and wire mat- 
tresses have supplanted the ancient feather-bed ; iron 
has taken the place of wood in many bedsteads, tables, 
and chairs. There remains, however, abundant room 
for still further improvement. 

The bed should be placed with its head against the 
middle of one of the walls, so that access can be 
gained to it on either side, and the air pass freely 
around it. The chamber ware should be kept in a 



KITCHENS AND SERVANTS. 161 

commode. There should be no direct communication 
from a sleeping apartment to either a conservatory or 
a water-closet. And the windows should have shades 
rather than curtains. 

THE KITCHEN AND ITS FURNISHING. 

Too little regard is paid to the furnishing of the 
kitchen by American housewives. "Were they to 
study the comfort of their servants a little more, these 
would be less the "plague of life" than they now are. 
We have repeatedly seen the kitchens of "first-class" 
houses so built and so furnished that the only wonder 
was that any neat girl could be induced to remain. 

Basement kitchens are to be wholly condemned. 
They are always damp, gloomy, foul-smelling, and 
insalubrious. Small kitchens are little better. The 
odor and steam from cooking, washing, and other 
household avocations must find free exit and not be 
confined. 

What the kitchen ought to be is a large room a foot 
or two above the ground, with good-sized windows on 
at least two sides, provided with a wide ventilating 
flue, an abundant supply of water, excellent drainage, 
and an outside porch open on two sides, and closed on 
that which is most exposed to the weather. It should 
be separated from the rest of the floor by a short 
passage-way, and should have a dry, clean cellar. 

The walls and wood- work should be painted light 

brown, the ceiling whitewashed, the floor of the best 

quality boards either oiled or covered with oil-cloth. 
11 



162 ON HEALTHY DWELLING-HOUSES. 

The range or cooking-stove used should be provided 
with a flue to carry off the heat in warm weather. 
The fire should be so placed as not to shine directly 
upon the face in any cooking operations. Smoke, 
dust, and gases should find immediate escape. 

The sink and washtubs should be so constructed as 
not to pen up foul air and dirt, but allow free circula- 
tion of air under and around them. Some builders 
carry the hot-water pipes outside the plastering, which 
is a neat device, as otherwise their warmth is a great 
attraction to numerous insects. 

The gas or other light should be located so as to 
illuminate the stove or range so that in the evening 
cooking can conveniently be carried on. 

For sinks, galvanized iron or zinc is better than com- 
mon cast iron. Stationary washtubs, when, desired, 
should be of soft wood well painted, or of soapstone. 

In conclusion, we recommend mistresses of house- 
holds to take pains to make their servants comfortable, 
by fitting up the kitchen and the servants' chambers 
neatly and attractively. Now and then they will 
have to complain of an ungrateful return, but, in the 
long run, they will find themselves amply repaid by a 
marked increase of willing service and domestic com- 
fort. 

NEWLY-BUILT HOUSES. 

"We have now gone over our model house, in at 
least a cursory manner, from cellar to attic and parlor 
to kitchen. We have even furnished it, in accordance 



CAUTIONS ON MOVING INTO A NEW HOUSE. 163 

with as sound principles as fashion countenances. 
And we are now ready to move in and have the house- 
warming. 

But here Hygiene steps in again, and recommends 
that the literal house-warming take place before the 
moving. For all know that newly-built houses are 
not so healthy as those which have been inhabited for 
some time. They are damp, and their freshly plas- 
tered walls prevent ventilation through the brick-work. 
If you are obliged to be the first occupant of a house, 
burn a few tons of coal in it before you subject your- 
self to the influence of its damp atmosphere. Three 
months at least should elapse after the plastering is 
done before the rooms should be inhabited. 

The painting, too, must be allowed to become 
entirely dry. The lead paint used on the wood- work 
will otherwise produce symptoms of lead-poisoning in 
those sensitive to its effects. We have known more 
than one case where this has occurred. 

The observation is often made that the owner of 
some unusually fine mansion does not live long after 
entering on its enjoyment. Frequently the reason 
is that he moves in too soon, and succumbs to some 
of the noxious influences which arise from the damp- 
ness and fresh paint. 

In Berlin there are a class of persons who, having 
no homes of their own, volunteer to live in houses just 
finished and take care of them until they are thoroughly 
dry, which in that humid climate requires many months. 
They are called TrocJcemvohner, and are a conspicu- 
ously unhealthy class, crippled with rheumatism, 



164 ON HEALTHY DWELLING-HOUSES. 

broken with coughs, and doubled with cramps. They 
vividly illustrate how insalubrious such an undertak- 
ing is. 

OLD HOUSES. 

If one must be cautious about entering a new house, 
he should be doubly so about occupying a tenement 
which has been long standing, and which has been 
absorbing for years the exhalations of various occu- 
pants. 

Before buying such a tenement, we should study 
closely not merely the deed, but its history and tradi- 
tions as well. Shun a house which has a bad sanitary 
record, no matter how free from causes of disease it 
seems to be. Those causes are sometimes beyond our 
ken, while yet they are present and active. A house 
where there has been much sickness and many deaths, 
no matter from what diseases, is not an "eligible pro- 
perty," and often proves dear at any price. Such a 
history is worse than a flaw in the title. 

An old house in Europe means one built about the 
time of the Crusades or the Reformation; in the United 
States, one whose date carries us beyond the war with 
Mexico seems already verging towards a respectable 
age, and one which was standing during "the Revolu- 
tion" is regarded with veneration as a monument of 
hoar antiquity. The art of house-building — domestic 
architecture — is of recent growth, and few dwellings 
constructed five-and-twenty years ago, can show any 
of those "modern conveniences" which are now found 
in even very humble residences. 



CAUTIONS IN MOVING INTO AN OLD HOUSE. 165 

For this reason an old house is rarely a satisfactory- 
purchase, as it costs well-nigh as much to tear it in- 
side out and insert water-pipes, flues, ventilators, etc., 
as it does to build outright. 

"Whenever an old house is reoccupied, it should un- 
dergo a most prolonged and searching cleansing and 
disinfection. The old paper should be carefully scraped 
from the walls and burned, the cracks in the walls and 
floors filled with putty or cement, the cellar floor new- 
laid, the wood-work repaired wherever dry-rotten or 
decayed, the roof patched, and especially all accumula- 
tions of refuse in the yard, outhouses, closets, or privies 
scrupulously removed. The earth, sodden with slops 
around the kitchen, should be carted away and re- 
placed with that which is fresh and dry. Chips, shav- 
ings, and scraps should be burned. Ceilings should 
be whitewashed, and as much air and light be admitted 
as possible. Fires in the furnace or stoves should be 
maintained for a week or two before the family moves 
in. 

If these precautions seem unnecessary and onerous, 
they will not when our readers learn that in repeated 
instances the most fatal maladies, such as puerperal 
(childbed) fever, malignant scarlet fever, diphtheria, 
and typhus fever, have been propagated from tenant 
to tenant, and from owner to owner, because, through 
ignorance or indifference, no such care was taken. 

There are single wards in hospitals which have 
been known to retain for years, and in spite of every 
measure, the poison of a contagious disease. And if 
this is so in institutions constantly under the care of 



166 



ON HEALTHY DWELLING-HOUSES. 



experienced nurses and physicians, what may we ex- 
pect from long-closed, ill-cleaned old houses? Many 
instances where contagious diseases seem to have 
arisen spontaneously in a family can be traced, with 
every shade of probability, to their moving into apart- 
ments which at some previous time had contained 
patients suffering from the same maladies. 




CHAPTER VI. 

OX EXERCISE. 

CONTENTS. 

The objects of exercise — Walking — Riding and driving — Precautions in 
travelling — Various exercises — Light gymnastics — Rowing — STvimnnng — 
Dancing — Boxinsr — On training. 




HE slothful servant who received his talent 
and buried it in the earth was called by his 
master a wicked one, and was punished by being 
deprived of even that which he had. The parable has 
many applications, and none more forcible than when 
taken to represent the physical powers with which we 
are endowed by nature. Use alone gives perfection. 
Who does not regularly and with discretion exert 
his muscular powers, will much cut short the time in 
which he has a chance to exert them. Exercise not 
only prevents disease, but sometimes cures it, as we 
shall show more fully hereafter when we come to treat 
of the "movement cure." 

At present we do not design to enter into details of 
the various methods recommended to develop the 
body, nor to furnish instructions in gymnastics, but 
only to state those general principles which should 
govern persons in using exercise, and to compare the 
various means most accessible and usual. 

(167 ) 



168 ON EXERCISE. 



THE OBJECTS OF EXERCISE. 



Physical culture has attracted much more attention 
of late than formerly, and most large institutions of 
learning have their gymnasia, where some theory of 
gymnastics or calisthenics is taught. Very many 
who attend them derive no benefit whatever; some 
are actually injured ; the wonder is that more are not. 
For the physiological principles which should direct 
all efforts for muscular development are commonly as 
little familiar to master as to pupil. 

Even the prevalent theory of gymnastics is radically 
wrong. It is, that there are a certain number of con- 
tortions which are to be done, or some given move- 
ments of a most unusual character to be performed. 
Usually the more strange and violent the contor- 
tion, the greater is the supposed proficiency. Then it 
is imagined that it is good training to do some move- 
ment, say to put up a dumb-bell, as many times as one 
possibly can. The greater the fatigue experienced, 
the more prompt and decided is the benefit expected. 

Now, all this is utterly erroneous and false. Exer- 
cise should be taken on no such principles. The few 
who can survive such a training, and maintain their 
interest in it, may indeed become athletes. But 
athletes, brilliant gymnasts, are notoriously short-lived, 
strange as it may seem. They die of heart disease, 
they break down under general nervous prostration, 
they perish with sudden congestions. Such health as 
theirs is delusive. 

Let us state at once what the physiological aim of 



THE PHYSIOLOGICAL AIM OF EXERCISE. 169 

all exercise is, and then we shall have clearer ideas 
how to attain it. It is to equalize the circulation and 
tlie nervous force. 

To explain : the student at his desk, busy all day 
over his problem, calls all the nervous force to his 
brain, and with it all the blood possible. His chest 
is bent, and he respires feebly; his limbs are at rest, and 
the blood flows sluggishly in them. Should he con- 
tinue thus for days and weeks, these unused parts 
lower their vitality, and thus become liable to disease. 
Etiquette forbids the Roman cardinals to walk abroad; 
the result is, that hardly one of them escapes ulcera- 
tions of the legs. 

This equalization of the blood and nervous fluid is 
essential to health. Exercise is the means to secure 
it. To do it effectively, each muscle and each organ 
should be brought into play frequently, but not neces- 
sarily to fatigue. Experiment and theory both show 
that exercise just short of fatigue is more efficacious 
than that pushed beyond it. 

The movement should at first be slow and regular, 
not short and quick. The former gives endurance 
and power; alertness can be sought later. It should 
be repeated from five to ten times. No movement 
whatever should be practised which throws the mus- 
cles into positions which they are never called upon 
to assume in ordinary actions. 

The usual fault of the circulation is that it is too 
much centred about the great organs of life; too little 
shared by the extremities and the surface. The heart, 
the brain, the lungs, the stomach, the liver, these must 



170 ON EXEKCISE. 

absolutely perform their daily labor, or the individual 
straightway dies. JSTot so the extremities. They may 
remain in entire rest for long periods, without visible 
deterioration of the general powers. 

But the repose is a deceptive one, and soon one or 
another of the organs of life, overloaded, overworked, 
overfed with blood which belongs elsewhere, gives 
out, becomes congested, and then farewell to comfort. 

THE PRINCIPLES OF EXERCISE. 

The sedentary man should, therefore, seek to bring 
the blood to his hands and arms, and his feet and legs. 
His exercises should not at first be of such vio- 
lence or character as to quicken his breath or cause 
his heart to beat with increased force, or so local as 
to pour all the blood to spare into one set of muscles. 
"Whenever, after exercise, he discovers his feet and 
hands to be cold, his face pale, his respiration oppressed, 
and a sense of nervous exhaustion, sometimes approach- 
ing faintness, present, then his exercise is doing him no 
good, but harm, and he must not give it up altogether, 
but modify it. 

The ambition to "develop muscle" and to perform 
feats is a foolish one. The health-seeker should judge 
of his progress not by these tests, but by the infallible 
one of his own sensations of increased physical and 
mental well-being. 

The beginner, at any unaccustomed series of exer- 
tions, will experience a soreness in his muscles, which 



EXERCISE SHOULD BE PLEASANT. 171 

lasts a few days. It should not interfere with his 
continuance, as it is of temporary character. 

No great effort should ever be made, either in the 
performance of a difficult feat, or in the long continu- 
ance of an easy one. To repeat with regularity a 
number of times — up to the point of fatigue — some 
simple movement, is much better practice. 

Those exercises are to be preferred which lead us 
into the fresh air and the sunlight; those which place 
us under conditions different from those to which we 
are subject at other times; which divert and fix our 
minds while they exert the body; and, beyond all else, 
which in themselves are pleasing and attractive to us. 
As Dr. Arnott says: — 

" Whene'er you sweat, indulge your taste." 

The forced labor of the tread-mill or the galley did 
little to keep in health the poor wretches who were 
condemned to it. To combine recreation and amuse- 
ment with muscular exertion is a happy success, and 
the perfection of physical culture. 

Boys, who require much exercise on account of their 
growth, instinctively devise all manner of games and 
athletic sports, thus fulfilling the demands of their 
systems. Some games are not less popular among 
adults, and supply a want. Billiards ask moderate 
exertion, and, when practised in rooms not filled with 
segar-smoke and the fumes of liquors, are innocent 
and beneficial. Bowling requires a severer use of the 
powers, and may be advantageously practised. 

The majority of such pastimes are, however, not 



172 ON EXERCISE. 

suitable to the greater number of those who need the 
exercise they give for sanitary purposes. These must 
seek it in some other direction. The readiest and one 
of the pleasantest is 



WALKING. 

This puts the muscles of the lower extremities in 
lively motion, and draws the blood from the brain, the 
lungs, and the heart. There is a moderately increased 
activity in respiration and circulation, the warmth of 
the body is augmented, and at each step the interior 
organs receive a slight jar which communicates to 
them tone and energy. Independently of these 
advantages, it is also the most convenient of all 
exercises, requiring no apparatus and no elaborate 
preparation. It can be varied at will, and is asso- 
ciated with a diversity of sights and sounds which 
divert the mind and agreeably occupy the senses, thus 
redoubling its benefits. 

The amount of walking which a person in health 
requires varies according to each one's powers. In 
England, where this is much more a favorite exercise 
than with us, and where every university student 
takes with regularity his " constitutional" promenade 
of an hour or two, from five to eight miles daily is not 
considered unusual. 

It is better not to walk for the sake of walking — 
which is at best very stupid business — but to walk 
with some object in view. There are many things to 
entice us into long walks. Some love hunting or 



THE PLEASURES OP WALKING. 173 

fishing, admirable sports, and unsurpassed for health ; 
others delight in botanizing, in collecting minerals, or 
in some other department of natural history ; or the 
love of travel simply may be sufficient reason. A 
pedestrian tour, planned, let us say, in the month of 
October, amid the ripe cornfields and the varied 
foliage of an American autumn, what more delightful 
could be suggested! This is the true way to enjoy 
travelling, not to be hurried along in a smoky car, day 
and night, on an interminable railroad. As Goethe 
says in his "Wanderer's Song": — 

From the mountains to the champaign, 

By the glens and hills along, 
Comes a rustling and a tramping, 

Comes a motion as of song. 
And this undetermined roving 

Brings delight and brings good heed, 
And thy striving, be it with loving, 

And thy living, be it indeed. 

In regard to the hour which should be chosen for a 
daily walk, much necessarily depends upon the obli- 
gatory employment of our time. When we are able 
to choose, the two hours after breakfast and the two 
before sunset will be the best. Observers of the 
weather will notice that when the day is rainy, gene- 
rally the rain ceases for about an hour before sunset. 

Of course it is essential that the feet be dry, the 
shoes comfortable, and that no unnecessary exposure 
be incurred. 



174 ON EXERCISE. 



RIDING AND DRIVING. 



Horseback exercise is probably the "very best" for 
those with a tendency to pulmonary consumption or 
to liver disease. It is also possible to the gouty the 
rheumatic, and the lame, whose maladies interfere 
with their pedestrian pleasures. 

The series of vibrations which are imparted to the 
central organs by the steps of the horse are precisely 
the movements required to disperse congestions and 
regulate the action of the heart. In repeated instances, 
we have known most excellent results follow regular 
and moderate equestrian exercises. They should be 
preferred on the road, and not in the confined and in- 
salubrious air of riding-schools. The fresh air and 
invigorating scent of green fields and flowers con- 
tribute much to the benefit as well as the enjoyment 
of a ride. But, as we have said, the chief advantage is 
the jolting. After some preliminary practice, which 
should never be violent, a rough horse may be se- 
lected. 

A well-known physician of Philadelphia, who, in 
his youth, was seriously threatened with consumption, 
cured himself by removing the springs from his car- 
riage, and allowing himself to jolt over the cobble- 
stones all day long in his rounds to see his patients. 
This was the same effect which is attained by horse- 
back exercise. 

Some complaints, however, forbid its employment. 
They are, ruptures and a tendency to them, piles, some 



THE SEASONS FOR TRAVELLING. 175 

varieties of heart disease, female diseases, and affec- 
tions of the bladder. 

Sufferers from these, and all who are too weak or 
too timid to trust themselves on horseback, can derive 
advantage from driving. The modern carriage, it is 
true, is so balanced on its springs, so padded and stiff, 
that the exercise it gives is gentle indeed. But, on 
that very account, it is the more suitable to the debili- 
tated invalid, combining passive motion with fresh 
air and the pleasing variety of the country. 

The days of journeys in one's own vehicle have gone 
by, but now and then it is a delightful change to travel 
with good horses, cheerful company, and a comfortable 
carriage through the remote rural districts, still untrod 
by the iron horse. The hypochondriac will drop his 
load of cares by the wayside as Christian did his bun- 
dle, and the nervous invalid will derive strength and 
pleasure from the novelty. 

PRECAUTIONS IN" TRAVELLING. 

Whenever travelling is undertaken for health, several 
precautions must be observed, or it will fail of its ends. 
The season must be either spring or autumn, so that 
one is exposed neither to the sultry heats of summer, 
nor the bitter cold of winter. All anxieties and cares 
about business and home affairs must be left behind, 
for worrying about the absent is to the last degree 
depressing and vain. At first, short stages should be 
undertaken, and at all times excessive fatigue must be 
avoided. Days of repose should be frequent, and on 



176 



ON EXERCISE. 



no account should the journey be prosecuted at night. 
Not only should the time given to sleep be sufficient 
and at regular hours, but the meals should be secured 
at fixed periods of the day, and the general habits of 
life be broken in upon gradually and with caution. 
Personal cleanliness, both by bathing and frequent 
changes of the clothing, should be even more scrupu- 
lously studied than at home. Novelties in diet should 
be ventured upon with hesitation, and every species 
of excess shunned. 

VARIOUS EXERCISES. 

Of the many popular varieties of exercise we shall 
briefly mention the most prominent, with their especial 
advantages. The principles which should govern the 
employment of general gymnastics and calisthenics 
have already been mentioned. Of their varieties, the 



LIGHT GYMNASTICS. 

recently so prominently advocated and introduced into 
many schools, are one of the best. The movements call 
pre-eminently into play the extremities and the super- 
ficial muscles, thereby, as we have explained, relieving 
the congestion of internal organs — preventing, as it 
were, the " centralization" of the blood, as dangerous 
a tendency in the body corporeal as in the body politic. 
They are well adapted to both sexes and to all ages. 
Under the name parlor gymnastics they have been 
introduced into private families, with much benefit. 



THE PERILS OF DANCING. 177 

The apparatus is simple and inexpensive, and allows 
a large number of movements. 

The li^ht dumb-bells and the Indian clubs are well 
calculated to afford a great variety of exercises for the 
upper extremities and muscles of the chest, neck, and 
abdomen. In cases of dyspepsia depending on want 
of vigor, and where there is no tenderness on pressure, 
they frequently bring about a rapid and permanent 
cure. 

ROWING 

Develops the arms and chest, but should be combined 
with exercise of the lower extremities to act with full 
benefit on the health. 

SWIMMING, 

Which is a valuable art to acquire, demands consider- 
able strength, and those with heart or lung disease are 
rarely improved by it. The same is true of 



DANCING. 

Indeed it should be banished altogether from the 
category of healthful exercises, as it has already been 
from that of religious rites. Its character has changed 
since the time when our ancestors in merry England 
danced on the greensward around the Maypole and on 
the verdant turf of the village common, or since David 
" danced before the ark," singing psalms of praise to 
Him who had rescued him from the hands of his 

12 



178 ON EXERCISE. 

enemies. !N"ow dancing is an insane twirling and 
spinning in overheated rooms, late at night, the atmos- 
phere laden with dust and the emanations of the hot 
and crowded assembly. This simply deserves unquali- 
fied reprobation on the part of the hygienist. Many a 
feeble girl has received the last and fatal blow to her 
health in the mazes of the waltz; many a year of 
chronic misery has been entailed by its unwholesome 
surroundings. 

BOXING 

Has been at periods a fashionable amusement in this 
country, though for self-defence our national temper 
takes more kindly to less unequal weapons than those 
which nature has provided. It is for those robust 
enough to practise it a most admirable exercise, 
developing the muscles of the whole frame, educating 
the eye, and giving both power and promptness to the 
motions. But it is very unsuitable to the feeble and 
those with weak and irritable hearts. The heroes of 
the pugilistic ring very rarely reach an advanced age. 
This is partly attributable to the excesses in which 
they indulge and the severe handling they occasionally 
experience, but it is also in a measure the consequence 
of over-exertion and over-training. 

QUOIT-PLAYING, 

An ancient and popular rural sport, should be more 
cultivated than it is. Few exercises tend to develop 



CAUTIONS AS TO TRAINING. 179 

more gracefulness of motion, and are less attended 
with accidents. 

ON TRAINING. 

Those who contemplate taking prominent part in 
the popular athletic contests of the day are accustomed 
to prepare themselves for the strife by "going into 
training," as it is called. This means by adopting 
that course of regimen and exercise best calculated to 
develop the maximum muscular power of the indivi- 
dual in the shortest time. 

Not unfrequently, owing to an ignorance of the 
maxims that should govern them at such times, and 
impelled by an ambition to win, young men overdo 
their training, and seriously injure their constitutions. 

It should, therefore, be entered upon with due 
caution, and carried on intelligently. 

In training for any kind of severe exercise, great 
attention must be paid to diet and to the habits of 
every-day life. Early rising, regularity in eating, and 
perfect cleanliness of the skin, are important points. 
An animal diet is preferable to a vegetable regimen, 
and the meat should be easily digestible, and not over- 
fat. Starches, being somewhat difficult of digestion, 
should be sparingly used. Alcohol, tobacco, and snuff 
are inadmissible, but tea and coffee may be used in 
moderation. A complete bath should be taken at least 
once a day, and the surface of the skin subjected to 
friction. Eight hours' sleep will not be too long. 
Much exercise is not desirable before breakfast, 



180 ON" EXERCISE. 

because at that time the stomach is without food ; but 
that meal should be taken as early as possible. Many 
persons practise severe exercise for a few days or 
weeks, and then abandon all active habits for perhaps 
a few months. This is what might be well termed 
the intemperance of exercise. Regularity in the 
motions of the body, as in everything else, is desirable; 
and men should always be in sufficient training to 
enable them to take a long walk, or to play a good 
game of ball, with the certainty that they would not 
suffer from muscular pains on the following day. 

After the contest is over, the habits of exercise 
should be diminished gradually, and only after some 
weeks the ordinary habits resumed. 

There is much doubt whether the periodical seasons 
of training which are passed through by most athletes 
contribute any real benefit to the general health. They 
are more likely to favor the development of the seeds 
of disease of the brain or heart. 





CHAPTEE VII. 

ON REST AND SLEEP. 

CONTENTS. 

Change of occupation — Recreation — Sleep ; amount of sleep ; hours of sleep ; 
how to induce sleep ; to escape bad dreams ; the awakening — The bed and 
bedclothing — Night-clothing — The bedfellow — The chamber ; ventilation ; 
warming ; presence of plants ; of odors. 

XEECISE and rest, activity and repose, are the 
opposite conditions essential to life. The regu- 
lation of the latter is as important as of the former ; 
more so, perhaps, for we can exist, and for a time com- 
fortably, without regard to exercise, but rest is a ne- 
cessity we cannot escape. 

CHANGE OF OCCUPATION, 

In one sense, is rest. It relieves the organs which are 
fatigued, though it calls others into play. To be able 
thus to rest is a great art, and one of the elements of 
conspicuous success. The most eminent scholars, and 
the workers who have accomplished most, have pos- 
sessed this faculty. The Chevalier Bunsen was dis- 
tinguished not less for his knowledge of Egyptian 
antiquities, and his extensive acquaintance with church 

history, than for diplomatic skill. It is related of 

(181) 



182 . ON REST AND SLEEP. 

him that in his study he had three desks, one devoted 
to each of these departments of learning. When 
fatigued with study of one subject, he would cross to 
another desk, and find, in the new direction it gave 
his thoughts, renewed vigor. 

Men of versatile minds, who combine depth and 
accuracy of knowledge with their versatility, have 
the faculty of finding rest to a remarkable extent in 
changing their studies. An extraordinary example 
was the illustrious Alexander von Humboldt, whose 
vast intellect embraced all the natural sciences, and 
who, in addition, found time to write exhaustively on 
history, linguistics, and politics. He accomplished so 
much because, throughout his long life, he gave but 
four hours out of the twenty-four to sleep. The va- 
riety of his pursuits was sufficient rest. 

But we are far from holding up such examples for 
imitation. The result might prove disastrous, as few 
are gifted by nature with this happy faculty. Gene- 
rally, the mind requires entire relief from labor, either 
in recreation or sleep. 



RECREATION. 

"Writers on hygiene have spoken much of sleep, 
little of recreation. Yet it is as essential to full health 
as sleep itself. Distrust the man who assures you 
that he finds recreation enough in his business. He 
is deceiving himself or you. He may think so, but 
the time will come when he will see his error and re- 
pent it bitterly. 



HOURS OF RELAXATION AND AMUSEMENT. 183 

A part of each day should be deliberately set aside 
for relaxation and amusement. People may say that 
you are wasting time, but the end will prove that you 
are saving it. It is a foolish economy that would 
devote the whole of the twenty-four hours to eating, 
sleeping, and working. The nursery rhyme is right 
when it tells us — 

" All work and no play, 
Makes Jack a dull boy." 

The intellect is brightened, the boy strengthened, 
and the labor power increased by a certain amount of 
recreation. 

"What shall it be, and how much time ought we to 
give to it ! 

Here again we meet with the difficulty (which, for 
that matter, encounters us everywhere in this science) 
of laying down a rule of universal application. Let 
it be something which leaves no sting behind it, 
nothing contrary to the laws of health or morals, 
something that removes us as far as possible from the 
thoughts and manner of our daily labor. Agreeable 
conversation, the delights of art in its manifold forms, 
unexciting games, the lighter kinds of reading, 
spectacles, and a hundred other ways suggest them- 
selves from which to choose. An hour or two daily 
given to such relaxations will fit us the better to do 
the work our hands find for them. 

One of the characters in the novel of "Wilhelm 
Meister says every person, to maintain his intel- 
lectual powers at their full measure of culture, should 
daily hear at least one strain of excellent music, see 



184 ON REST AND SLEEP. 

one fine painting or statue, and read one poem or 
dramatic scene of acknowledged merit. Applying the 
advice to our physical nature, we would say that 
every person, to secure the best health, should give at 
least one hour each day to exercise, one to recreation, 
and one to his principal meal. 

SLEEP. 

We may rest one limb or set of organs by calling 
another into play, but ere long we must accede to the 
imperative summons of Nature, and give our whole 
bodies rest in sleep. This ever mysterious condition 
of life in which all sensation and thought seem to 
cease, demands from us nearly or quite a third of our 
whole time. ~No effort on our part can postpone it 
very long. It is said that alleged criminals, sentenced 
to the rack, have fallen asleep in the midst of their 
tortures. Soldiers will sleep amid the roar of cannon 
and the bursting of shells. A terrible punishment 
is practised in China. The victim is kept awake by 
being pricked with sharp bamboo canes whenever he 
falls asleep. The wretched sufferers are driven into a 
raging delirium about the seventh day. 

It is not safe to resolutely struggle against the 
demands of the system in this respect. Hard stu- 
dents have brought on brain fever by too much 
limiting their hours of rest, and insanity is also a 
not unfrequent consequence of the same deprivation. 
Then, too, it is possible that when sleep is indulged, it 
may be so profound that there is no awaking. This 



THE SLEEP WE REQUIRE. 185 

was the tragic end of the celebrated French surgeon 
Antony Portal. 

AMOUNT OF SLEEP. 

The amount of sleep which it is best to take depends 
on several considerations. Extreme youth and extreme 
old age require ten or more hours ; in adult life most 
healthy persons will do well on eight hours ; nervous 
and spare persons demand less than the phlegmatic 
and corpulent. The habit of the individual controls 
him much. Some by gradual retrenchment can reduce 
their time of sleep to five or even four hours, but the 
attempt is a dangerous and a futile one to the majority. 

Too much sleep is also injurious. It debilitates the 
intellect, and renders the bodily functions sluggish 
and inert. Occupation, of course, must decide in 
many cases as to the precise length, but it is an error 
to suppose that the brain-worker needs much less 
sleep than the hand-worker. Though the sense of 
muscular fatigue is less, the nervous exhaustion is 
quite as great, and this it is that in either case should 
be remedied by a state of quiet. 

HOURS OE SLEEP. 

These vary much with the different classes of 
society and occupations. The laborer, the farmer, 
and most out-door workers are guided by the light, 
and give the day to labor and the night to rest. In 
the more refined and wealthy classes there is always a 
tendency to encroach upon the night hours with 



186 ON REST AND SLEEP. 

amusements and study. Although the wise maxims 
which we all learn in early youth inform us that 
"night is the time to sleep," and that "early to bed 
and early to rise" is the secret of health as well as 
wealth, we must confess that proof is lacking to show 
that it makes any difference in point of health what 
portion of the twenty-four hours we devote to sleep, 
so that it is regular and sufficient. Here, again, habit 
becomes nature. 

The Spaniards of the better classes, in both America 
and Europe, accustom themselves to a siesta or nap 
from two to four every afternoon. It is almost a 
national custom. Many with us, who are not obliged 
to trouble themselves about bank hours, have the 
same habit. For elderly or feeble persons it is a wise 
usage, as it imparts strength which they need. For 
others, as unnecessary, and tending to indolence, it 
cannot be recommended. 



HOW TO INDUCE SLEEP. 

Few situations are more disagreeable than to go to 
bed with the full hope and intention to lose all con- 
sciousness in a few minutes, and to remain wide- 
awake, or sink into fitful and broken slumbers. 
Some persons, especially those of a nervous tempera- 
ment, suffer exceedingly in both these directions. 

The problem how to induce sleep will therefore 
interest them much. It has often been discussed, but 
not with always satisfactory results. The recommen- 
dation to count up to a hundred or a thousand is not 



THE REMEDIES FOE SLEEPLESSNESS. 187 

efficacious, nor does repeating the same phrase over 
and over again succeed better. A bath just before 
retiring is more effective; and in default of this, bath- 
ing- the face, neck, and hands in cold water will often 
accomplish as much. So far, as might be supposed, 
from making one still more wide awake, this soothes 
the nerves and calms the circulation. For sleepless- 
ness which comes on after a first nap, it is well to try 
getting up and walking once or twice around the 
room. The agreeable want which is felt on returning 
to bed often induces sleep quite promptly. 

Or Dr. Franklin's recommendation may be tried. 
He advised those troubled in this manner to rise and 
shake up the bed, with a view to change the air envel- 
oped in its coverings. This is often successful, par- 
ticularly in hot weather. 

There is something in the direction in which to lie. 
With the head to the north is the most soothing. 
Many persons will smile at this, but nervous and deli- 
cate temperaments readily feel the difference. A year 
or two ago Dr. Hughes Kennedy, of Dublin, proved 
the importance of this position in sickness, by the 
relation of a number of cases in point. "We knew an 
army surgeon who could not sleep with any degree of 
comfort except with his head to the north. In 1868 a 
physician of Magdeburg, Prussia, died at the extra- 
ordinary age of 105 years; he always largely attributed 
his long life and sound health to his. invariable habit 
of sleeping thus. The philosophy of the position is 
that it conforms to the magnetic meridian, in which 
direction a constant magnetic current is flowing. 



188 ON REST AND SLEEP. 

Bad sleepers should rise early. They should seek 
their rest at the natural .time, not in daylight. They 
should, moreover, never sleep in the afternoons, as is 
frequently done. 

The Eev. John "Wesley relates that when a young 
man he was troubled with sleeplessness, lying awake 
for an hour or two shortly after midnight. To cure 
himself, he rose at six instead of seven o'clock. But 
the wakefulness continued. He rose at five. It still 
troubled him. He set his alarm-clock at four, and 
sprang out of bed. He then found he not only slept 
soundly all night, but could do very well with only 
six hours' sleep, "and by God's grace," he continues, 
writing when eighty years of age, " I have retained 
this good habit for sixty years, and do not lie awake 
at night a quarter of an hour in a month." 

The cause of sleep is a diminution of blood in the 
brain. Therefore sleepless persons should avoid hard 
study, exciting reading or conversation, or any mental 
agitation for a half hour or hour before retiring. The 
latest meal should be taken at least two hours before 
bedtime, and tea, coffee, and all vegetable matters apt 
to decompose in the stomach and generate gas, should 
be excluded from it. 

The posture in bed deserves consideration. That 
which is generally most easy is lying on the right 
side, for this affords such support to the two weighty 
organs, the liver and the heart, as obviates their press- 
ing on the hollower organs around them. But no one 
posture should be constantly adopted, as it leads to 
deformity, and malposition of the inner organs. 



REMEDIES FOR SLEEPLESSNESS. 189 

The various artificial means in use for their sleep- 
producing power should be ventured upon with cau- 
tion. To one, and an excellent one, however, this 
warning does not apply. This is a glass of hot (not 
warm) water, swallowed just before lying down. It 
is an admirable and simple anodyne, and will be found 
on trial not to be unpleasant. The use of spirituous 
liquors for the purpose we do not approve. 

Opium and its proximate principle, morphia, is the 
most familiar of the medicinal preparations for this 
purpose. Many persons cannot bear it, on account of 
the headache and sick stomach it leaves behind it. 
It is a dangerous poison in all its forms. And " the 
drowsy syrups of the Bast" should never be used 
except under the direction of a physician. 

Chloral hydrate has recently been introduced and 
much praised as a most excellent drug for causing 
sleep, and leaving no after-effect. The latter is true 
in most instances, but in every five or six persons one 
will be found with whom it does not agree. "We 
shall speak of it again on a later page. 

A very agreeable anodyne is the garden lettuce 
(lactucarium). After partaking freely of its leaves 
in a salad, a very decided drowsiness steals upon one. 
Its juice is employed in medicine, and acts well in 
many cases. 

Hops also have a similar power. Sometimes ner- 
vous, sleepless persons are greatly improved by sleep- 
ing upon a pillow filled with hops. Strong hop tea is 
an efficient and palatable draft, taken just before 
retiring. 



190 OST REST AND SLEEP. 

With one or other of these resources, those whose 
sleeplessness arises merely from nervous tension will 
escape their troubles. But there are cases where they 
fail. "When this is so, the cause is of a serious 
character, and should be investigated with care. For 
obstinate 1 sleeplessness is sometimes a forewarning of 
insanity, and dangerous disease of the brain. 

TO ESCAPE BAD DREAMS. 

Many a person, like Hamlet, is "plagued with 
bad dreams," which make the night a terror, and the 
bed a scene of torture. The horrors of the night- 
mare are not comparable to anything else we experi- 
ence. "When habitual, they usually arise from dis- 
order of the stomach. Loading it with food, or eating 
even lightly of any indigestible substance, will very 
certainly evoke most disagreeable visions. The fami- 
liar rule about not eating anything for an hour or two 
before retiring, is an excellent one. We urge it upon 
those who are troubled in this manner. 

Persons troubled with nightmare, will relieve them- 
selves of it by taking the following draft on going to 
bed:— 



Take of— 

Carbonate of ammonia, six grains. 

Compound tincture of cardamoms, three drachms. 

Water, two ounces. Mix. 
Take in a single draft. 



Disease of the brain may cause bad dreams, but 
these grave maladies are fortunately rare. 



HOW TO AVOID BAD DREAMS. 191 

When not habitual, bad dreams are generally o wing- 
to some indiscretion in diet, to bad air, to mental 
anxiety, or to position, all avoidable causes. Very 
many suffer thus when lying upon the back, probably 
because, in this position, the blood centres around and 
presses upon the spinal column. They will find a 
simple and handy remedy in tying a towel around the 
waist, with a stout knot in it immediately over the 
spine. Whenever in sleep they unconsciously roll 
over on the back, the pressure of the knot awakens 
them. Nightmare or incubus nearly always arises from 
position, and can, in this manner, be prevented. 

THE AWAKENING. 

To wake a person abruptly from sleep, always pro- 
duces disagreeable sensations, and to some the shock is 
so great that it causes faintness. Usually, it requires 
some minutes before we recover our complete con- 
sciousness. This should be respected, and the custom 
of violently and abruptly awakening persons, espe- 
cially children, should be discarded. The celebrated 
French essayist, Michel de Montaigne, relates that his 
father insisted so much on the importance of this 
point, that he was accustomed to awake him, when a 
child, by playing upon some musical instrument. 
Possibly to this thoughtful care the rare genius of 
the son was in a measure due. 



192 ON BEST AND SLEEP. 

THE BED AND BED CLOTHING-. 

Nothing which concerns health is too minute or 
insignificant for the hygienist. Even the art of 
making beds is one with which he must be ac- 
quainted. 

As to the bed itself, he would advise a soft yet light 
material, which will allow the aif to permeate freely, 
which will keep as clean as possible, which will offer 
as few homes for insects as may be, and which retains 
but little of the secretions of the human body. 
Fortunately we can take our choice between several 
such materials. Well-curled, clean, Russia hair, 
prepared sponge, springs, and especially wire, are all 
used extensively in manufacturing mattresses, and are 
all excellent articles. 

In the country, corn-husks, straw, and cotton are 
much employed. The contents of such beds should 
be changed every three months, as they absorb the 
emanations of the body. 

Old-fashioned people think a hard bed is healthier 
than a soft one — that it makes the young folks 
"hardier." The truth of this is questionable, except 
in certain diseased conditions. The soft feather-beds 
of ancient times, now fortunately almost obsolete, pre- 
vented any circulation of air around the body, and for 
this reason were objectionable; but nowadays mat- 
tresses are manufactured of brass and iron (wire), 
which are more prized by the delicately nurtured than 
was his couch of rose-leaves by the Sybarite of yore. 
And with reason; for, while soft and elastic, they do 



THE MATTRESS AND BED CLO THING. 193 

not smother one with their billows, and prevent trans- 
piration. 

The covers should be light, barely enough to keep 
one warm. When heavy, they are apt to cause a 
sense of fatigue, and the sleeper arises with a dulness 
or a slight ache in his head. Next the skin, linen is 
most pleasant and healthful, except to gouty or rheu- 
matic persons, or those who perspire much at night. 
These should invariably sleep on or between wool. 

The bedel othing and the mattress should be 
thoroughly aired every day, and the former be clean 
and dry. "We have known the foundation for fatal 
diseases laid by a neglect of the latter point. In 
hotels and large boarding-houses sufficient time is not 
given to allow the sheets to become thoroughly dry. 
Every traveller and visitor should never neglect to feel 
the sheets, and if they have even a suspicion of damp- 
ness, throw them off, and sleep between the blankets. 

The bolster and pillows should not be thick, so that 
they lift the head more than four or five inches above 
the line of the body. The habit of sleeping with the 
head much higher than the body is an objectionable 
one, because it throws the spine into an unnatural 
position and tends to produce curvature, and also to 
throw the head forward upon the chest. A small firm 
pillow is better than none at all. 

OTGHT-CLOTHING. 

The pictures which are preserved in ancient missals 
showing the private life of our ancestors in Europe in 

13 



194 OK REST AND SLEEP. 

the middle ages, teach us that it was their custom to 
divest themselves of all clothing at night, and sleep 
nude. The modern habit of wearing night-clothes is 
an improvement in a sanitary point of view. But our 
forefathers were right in so far as they slept in none 
of the garments they wore during the day. These are 
always more or less impregnated with perspiration, 
and the exhalations of the body, and often with dust 
and smoke. It is well to throw them all off, even to 
the undershirt, and dress ourselves anew for bed. 
Night-caps, though out of fashion, should be worn by 
those liable to neuralgia, rheumatism, catarrhs, or 
pulmonary weakness, and by the bald. 

The night-dress should be light, not constricted 
either at neck or waist by belts or buttons, and either 
of cotton, linen, or wool. The latter is to be recom- 
mended for feeble and rheumatic persons. The use 
of night-drawers might be dispensed with, as they 
secure no good purpose, and it is well to have the 
body as moderately clad as is comfortable. The night- 
dress, be it remembered, is not to give warmth. This 
must be done by the covers. 



THE BEDFELLOW. 

The close contact in which persons sleeping in the 
same bed are brought, influences very materially their 
health. Certain diseases are thus propagated, and while 
to some it is an advantage, to others it is the reverse. 

Experience abundantly proves that when an old and 
a young person sleep together, the old person is bene- 



THE BED-ROOM. . 195 

fited by the association, while the younger one loses ; 
the latter seems to transfer a portion of his health and 
activity to the former. The same is true of individuals 
with various chronic diseases ; they derive advantage 
from sleeping with robust young people, but these 
latter suffer for the strength they impart. 

Children should not be allowed to sleep together, 
nor with old people. Their constitutions may be 
injured, and they suffer other exposures. On the 
contrary, adults, elderly persons, and those of feeble 
circulation, are improved in health by the more equa- 
ble warmth which a bedfellow imparts, and by the 
presence of a stronger constitution. 

THE CHAMBER. 

Every wise householder or house-builder will devote 
more care to the construction of his sleeping-room 
than to his parlor. In the latter he may pass an hour 
or two daily; in the former he certainly spends a third 
or a quarter of his whole time, and in a condition of 
body which renders him far more susceptible to 
unhealthy influences. 

First, he will look carefully to the ventilation. Many 
plans to accomplish this have been suggested. None 
surpass the old-fashioned plan of having an open fire- 
place with an air-flue alongside of it, with a damper 
both at the ceiling and the floor. Fresh air has been 
much preached about of late, but not too much. The 
benefits of good ventilation at night are very percep- 
tible. With it, we wake refreshed, and with a good 



196 ON REST AND SLEEP. 

appetite for breakfast ; without it, we arise with fa- 
tigue, a bad taste in the mouth, languor in the limbs, 
and no appetite. 

In some of the barracks for United States soldiers, 
the authorities introduced improved methods of ven- 
tilation. The difference was straightway so perceptible 
that the post-commandant called attention regretfully 
to the much larger proportion of the ration consumed, 
and the consequent diminution of the post fund ! 

To ventilate by throwing open the windows, is often 
worse than not ventilating at all. "We have known nu- 
merous instances where severe colds, inflammations of 
the lungs, pleurisies, inflammations of the bowels, and 
miasmatic fevers were contracted thus. It is peculiarly 
unsafe for travellers and those of feeble constitution. 
At most, a crack an inch or two in width can be left. 
More than this, even in summer, is generally unsafe. 
The amount of space which each person requires is 
about one thousand cubic feet ; the whole of the air 
contained in which should be changed every hour. 

Warming the room can best be effected in ordinary 
weather by an open wood-fire. In health, we should 
never sleep in a room artificially warmed beyond 50° 
Fahrenheit. It is enough to "take the chill off" of 
the air. Modern houses are heated throughout by 
furnace flues, which can be readily regulated. Deli- 
cate and aged persons sleep more soundly in slightly- 
warmed apartments, and they should prefer them. 

The presence of flowers in a chamber is objectionable. 
The odor they emit, and the carbonic acid gas they 
evolve in the process of growth, are found to inter- 



THE FATAL ILLNESS OF PRINCE ALBERT. 197 

fere vath the soundness of sleep. So, also, there are 
good reasons why no one should take one of the lower 
animals, a dog or a cat, to bed with them. Several 
diseases can be traced to this habit. 

No matter how large the room, very many persons 
should not be put to sleep in it. Although theoreti- 
cally there may be space for them all, practically it 
breeds disease. Physicians recognize a peculiar subtle 
emanation from the human body, which is greatly 
intensified by congregating them together, which is 
called "crowd-poison." It is the cause of some malig- 
nant and fatal diseases, and is the ever-present obstacle 
to massing men densely. 

The sleeping-rooms in some of the most expensive 
modern houses open into a water-closet. This is a 
reprehensible mode of building. No matter how care- 
fully laid is the plumbing, it is impossible altogether 
to prevent some foul air reaching the apartment. This 
oversight was the cause of the death of the late Prince 
Albert of England. In his case, it brought on a low 
fever, which soon carried him off. The use of a com- 
mode in the sleeping-room, or, still worse, of a chamber 
vessel, is yet more strongly to be condemned. For 
those who cannot dispense with something of the kind, 
the modern portable earth-closet is a safe, cheap, and 
convenient article. 



SLEEP-WALKING. 

"Very curious incidents are narrated in medical works 
about those persons who have a habit of walking in 



198 



ON REST AND SLEEP. 



their sleep. This malady — for it cannot be regarded 
as anything else — is frequent in childhood, and is 
always a cause of anxiety to parents and associates. 
The popular notion that sleep-walkers never hurt 
themselves is far from true. Though at times they 
manifest extraordinary muscular power, there are not 
wanting instances where most serious results have 
happened, as, for example, where persons have walked 
out of windows or fallen from the roofs of houses. 

Some of the adventures of somnambulists could 
hardly be credited, were they not on authority that leaves 
no room for doubt. A trustworthy author relates that 
a boy got out of bed, scaled a steep rock near the house, 
so precipitous that it would have baffled an expert moun- 
taineer, and brought from the summit an eagle's nest. 

In other instances the accustomed labors of the day 
are continued. An Italian waiter, named Negretti, 
would often repeat in his sleep the accustomed duties 
of the day, and would carry trays and glasses about, 
and spread the table with great accuracy, though his 
eyes were firmly closed all the time. 

Often it is observed that the eyes are wide open and 
staring, although " their sense is shut," for no notice 
is taken of lights, and the walker runs against objects 
in his way. In other cases, the somnambulist may 
use his eyes naturally, though he is in reality asleep. 
Castelli, whose case is vouched for by an Italian physi- 
cian, was found one night sound asleep, but translating 
a French book into Italian, and looking out the words 
in a dictionary! When his candle was extinguished, 
he arose and went to seek another light. "When any 



THE CURE OF SLEEP-WALKING. 199 

one conversed with him on any subject on which his 
mind was bent at the time, he gave rational answers; 
but he seemed to hear nothing that was said to him on 
any other topic. 

This activity in sleep is generally acquired during 
* youth, and it is at that period that efforts should be 
commenced to break up the habit, or, still better, to 
prevent it. It has been noticed that children who are 
allowed to go to sleep on the floor or lounge, and who 
are aroused into a state of half-consciousness, and sent 
to bed, will in time acquire the habit of rising and 
walking in sleep. Hence the rule should be enforced 
that they should go to bed before falling asleep, and, 
once asleep, any disturbance of their slumbers by being 
carried from one room to another, or the like, should be 
carefully avoided. 

The cure of the habit, when once formed, is not easy. 
Some have attempted by tying themselves to the bed- 
stead to prevent their walking ; but this has occasion- 
ally resulted in injurious sprains, and at other times 
the sleeper, with perverse ingenuity, unties the knot. 
Our opinion is that, in nearly every instance, if the 
sleeper will avoid sleeping on the back, he will break 
up the habit. This can readily be accomplished by 
fastening a towel around the body, with a large hard 
knot in it just over the backbone; so that when in 
sleep he unconsciously rolls over on his back, the pres- 
sure of the knot will awaken him. The popular 
remedy of dashing a basin of cold water into the face 
of the somnambulist, though efficacious, causes too 
violent a shock to be altogether safe. 



CHAPTEE VIII. 

THE PKEVENTION OF SPECIAL DISEASES. 

Section I. Hereditary Diseases. The prevention of consumption and 

scrofula ; of insanity ; of epilepsy ; of diseases of the heart ; of gout. 
Section II. Diseases Incident to Certain Occupations. The dangers 

of mental labor ; Diseases incident to indoor occupations ; To workers 

among lead and paint ; Workers in copper ; in phosphorus ; in iron. 
Section III. Contagious Diseases. How to avoid contagious diseases in 

general — The use of disinfectants ; Carbolic acid ; Permanganate of 

potash ; Sulphate of iron ; Sulphur ; Charcoal ; Quicklime ; Fresh earth ; 

The earth-closet. 
Section IV. Special Contagious Diseases. The prevention of scarlet 

fever; Smallpox ; Typhus fever ; Typhoid fever; Swamp fevers ; Cholera; 

Hydrophobia. 
Section V. Diseases not Contagious. The prevention of apoplexy and 

palsy ; Indigestion and dyspepsia ; Diarrhoea and dysentery ; Worms ; 

Diseases of the skin ; Sea-sickness ; Diseases of the eyes. 




N" the previous pages we have attempted to 
give in brief outlines those principles which 
must govern the individual in the ordering of his 
daily life. "We now approach a part of our subject 
which is of the utmost importance, and yet is one 
which is almost altogether neglected in every work 
on hygiene, whether popular or technical. We refer 
to the special precautions which it is proper for us to 
take, so as to avoid contracting any particular dis- 
ease to which we may be exposed. As almost every 
month of our lives we are forced by circumstances to 

( 200 ) 



THE PREVENTION OF HEREDITARY DISEASES. 201 

incur the risk of such exposure, it is of the utmost 
importance, for our own sake and for the sake of those 
who love us or who depend upon us, to learn and to 
use the means which science provides to escape the 
contagion. These we shall now give, and, we believe, 
for the first time in any connected manner. 

"With this purpose in view, all diseases naturally 
present themselves in two classes : those the tend- 
ency to which we have inherited from our parents, 
and those to which we are liable incidentally. This 
exposure may be either owing to the transmissible 
nature of the disease, or to the avocation in which we 
are employed. 

I. Hereditary Diseases. 

We have called attention at considerable length in 
our previous works ( The Physical Life of Woman, 
and The Transmission of Life) to the marvellous facts 
of hereditary transmission, and have shown that 
parents bequeath children not only houses and lands, 
but ineradicable proclivities to disease and suffering, 
aye, almost to misery and crime. Those three mala- 
dies which destroy annually more than one-fourth of 
all who die — pulmonary consumption,, scrofula, and 
insanity — are peculiarly the legacies of ancestors. 
The child is born with a fatal liability to them, and 
only by most judicious training in youth, and by un- 
remitting diligence in age, can he escape the uniform 
tendency to premature death or loss of mental power. 

There are other hereditary diseases, less terrible in 



202 THE PKEVENTION OF SPECIAL DISEASES. 

their nature, but not less desirable to avoid, such as 
gout, rheumatism, asthma, epilepsy, and heart disease. 
This is an ugly list, and the more grateful should we 
feel, therefore, that science has provided means which, 
if early and sedulously employed, will enable our chil- 
dren to erase their dreadful imprints from their con- 
stitutions. 

* • 

TO AVOID CONSUMPTION AND SCKOFULA. 

These are at once the commonest and the most 
fatal of all the hereditary taints.- "We class them 
together, because many eminent observers consider 
them convertible diseases — correlated, as the scientific 
term is. Moreover, the precautions to prevent their 
development are, in many respects, the same. These 
precautions range themselves under three headings : 
education (physical and mental), occupation, and 
marriage. 

EDUCATION. 

This should commence before birth. The intimate 
relationship of the mother's mind and body with the 
well-being of her unborn babe is now fully recognized 
by physicians. We have, however, given such ex- 
tended directions on this subject in the first of the 
works above alluded to, that we shall not enter upon 
it here. ^ 

After birth, the first point that demands attention 
is the nourishment of the infant. This should always 
be healthy human milk. If the mother is strong, and 



TO AVOID CONSUMPTION AND SCROFULA. 203 

has abundance of milk, there is no objection- to her 
nursing her own child; but if herself feeble, or suffer- 
ing from disease, a healthy wet-nurse should be pro- 
cured. Still more important is it that a nursing infant, 
whose mother has the disease, should be immediately 
taken from the breast and intrusted to a wet-nurse. 
The health of the mother as well as the infant requires 
this. 

If the father has the disease, and the mother's milk 
is inadequate or of poor quality, and the infant is 
under the age of six months, the same change should 
be made, rather than supply the deficiency by artificial 
feeding. Children who are weaned, should have plain 
but nutritious and easily digested diet, a part of which 
should be milk. If the predisposition to consumption 
is strong, a little alcoholic stimulant may be allowed 
three or four times daily in the milk, though with the 
risk of creating an appetite for it. To an infant, two 
or three drops of Bourbon whiskey may be given for 
each month of its age, and to children of three to five 
years a teaspoonful. 

Residence in an airy and salubrious locality, out- 
door exercise, a scrupulous avoidance of exposure by 
which a cold might be contracted, are necessary in 
order to the continued latency of the tendency. Loss 
of flesh or appetite, or other evidences of failing health, 
indicate the need of additional measures of a thera- 
peutic character. 

Iron, with cod-liver oil, iron and quinine, elixir of 
calisaya bark, or other tonic, should be employed in 
connection with the alcoholic stimulant and suitable 



204 THE PEEYEKTION OE SPECIAL DISEASES. 

regimen. By the employment of such precautionary 
measures, as soon as indicated, multitudes of children 
might be saved from this disease, who now perish. 

The three requisites for the baby's health are: fresh 
air, cleanliness, and sufficient warmth. The general 
treatment of infants, which we have recommended in 
our work to mothers, will meet most of the require- 
ments in these special cases. 

As soon as intelligence dawns, mental training must 
begin. The child should be managed with tenderness 
but firmness, no undue stimulation of the faculties 
should be allowed, no desire to develop precocity ex- 
hibited. Scrofulous children are very frequently bright 
beyond their years, and indiscreet parents often urge 
them to studies which are perilous to their future. 
Such children should be retarded in their mental 
growth, and have their aspirations directed to physical 
rather than intellectual superiority. 

The decade between eleven and twenty-one years is 
the most critical period of life for scrofulous and .con- 
sumptive children. The precautions proper at all 
times should then be redoubled, and a new element — 
the control of the passions of the sex — enters upon 
the plan, and a most important one it is. 

OCCUPATION. 

The debilitating effects of impure air -and in-door 
employments show themselves very soon in such indi- 
viduals. It is, therefore, desirable that a taste should 
be cultivated for pursuits and employments which 



OCCUPATION'S FOR CONSUMPTIVES. 205 

keep one constantly in free exercise in the open air, 
and give occupation to the mind without excessive 
fatigue. Exercise in a pure air is perhaps the most 
powerful preventive agent in these diseases which can 
be suggested. 

The medical statistics of England show that con- 
sumption is less prevalent in the interior than near 
the sea (being in this respect the reverse of heart 
disease). Avocations which are connected with mari- 
time commerce are therefore not desirable. 

It is credibly asserted that artisans in copper, and 
workmen in tallow-chandleries, are very much less 
subject to consumption than others. On the contrary, 
printers and other indoor operatives, who are employed 
in rooms where much gas is burned, suffer from it to 
an unusual degree. One gas-jet consumes more air 
than three men, hence the unhealthiness of brilliantly 
lighted apartments. 

Drovers, and others, whose business requires them to 
be on horseback several hours daily, rarely die of con- 
sumption. Probably no variety of movement is more 
advantageous for those suffering from pulmonary 
debility than this. 

Any occupation which forces one to breathe an 
atmosphere laden with dust is injurious to the lungs, 
and in the predisposed will excite the disease of which 
we are speaking. Grinding, polishing, wood-sawing, 
mining, etc., are included here. When, as is often the 
case, there is no choice but to continue them, entire 
prevention of their ill effects can be secured by a very 
simple contrivance called a "respirator," a disk of 



206 THE PREVENTION OF SPECIAL DISEASES. 

porous material worn over the mouth and nose, which 
will admit the air, but effectually exclude dust, gases, 
dampness, etc. 

The best respirators are made of charcoal, which is 
an excellent disinfectant, and purifies the air, as well 
as prevents the inhalation of any dust. A cheap and 
convenient one is a small and fine sponge-, or, one 
can readily be improvised by quilting a few layers of 
cotton together. 

The question of marriage, which is one of the utmost 
importance in this connection, we have so completely 
answered in our books addressed especially to the sexes, 
that we need not repeat here what we there have said. 

SPECIAL DIRECTIONS. 

In addition to these general rules, there are some 
special directions we shall give. A member of a con- 
sumptive family, no matter how apparently robust, 
should always remember the family tendency, and take 
precautions against it. He should invariably wear 
flannel next the skin, winter and summer. Exposure 
at night should be avoided as much as possible. 
Dampness must be shunned. The food should be 
light, palatable, and nutritious. Free use should be 
made more especially of the fat and heat producing 
articles, such as fat meat, oil, sugar, milk, butter, and 
starchy matters. Coffee and chocolate are beneficial, 
but tea is not to be recommended, as it possesses the 
power of increasing the action of the skin, which is an 
injurious tendency for consumptives. 



EXERCISE FOR CONSUMPTIVES. 207 

Those modes of exercise should be adopted in the 
first instance which warm the extremities while they 
give only moderate action to the lungs. As vigor 
increases, those which increase the rapidity of the 
respiration and act directly on the expansive power of 
the lungs should be commenced. Fatigue sJiould never he 
incurred, beyond a slight degree. The direct exercises 
of the lungs are by deep voluntary inspirations, and 
by speaking with a loud voice or singing. The former 
of these is very efficacious, and should be practised for 
fifteen minutes at a time, twice or thrice a day. The 
plan is simple. Standing erect, the hands at the sides, 
the shoulders thrown back, draw in the breath very 
slowly until the lungs are completely expanded. 
Retain the air a few seconds by an increased effort, 
then slowly expire it. Breathe naturally a few times, 
then repeat the inspiration, first expelling all the air 
possible from the chest. The eminent Professor 
Piorry, of Paris, even asserts that by this means those 
already clearly consumptive can (with other treatment) 
save themselves. 

Loud speaking and singing unquestionably have a 
good effect, but are inferior for developing the chest 
to the plan just described. 

PREVENTION OF SCROFULA. 

For the prevention and also for the cure of scrofula, 
when not too far advanced, there is the strongest testi- 
mony in favor of a residence of several months by the 



208 THE PREVENTION OF SPECIAL DISEASES. 

seashore, and sea-baths twice daily. No plan of treat- 
ment is anything nearly so successful. 

So well established is this fact, that a charitable 
society in Paris has instituted a large hospital on the 
seashore at Berck, France, for the gratuitous care of 
scrofulous children. The success has been most 
gratifying, even severe cases being restored to health 
in a few months. The patients who recover the most 
rapidly are those with scrofulous swellings under the 
jaws and on the neck, those with cold abscesses, white 
swellings, or stiff joints. The sores are washed twice 
daily in the sea-water, and carefully dressed. The 
children are encouraged to pass the time in the open 
air whenever the weather is pleasant. 

Even the most severe cases are rendered more com- 
fortable, except those where the disease has attacked 
the eyes (scrofulous ophthalmia) or the bones. 



THE PREVENTION OF INSANITY. 

In many respects the most fearful of all diseases is 
that which destroys the intellect, yet leaves life and 
seeming health. Very frequently, it is said in about 
one-third or one-half the cases, this sad condition 
arises from a transmitted tendency, which is aroused 
into action by some train of events, or bodily condition. 
Good results are certain to attend the resolute employ- 
ment of the means here suggested by preventive 
hygiene. A careful study of the causes that excite 
the outbreak teaches us what to avoid. 

Insanity is not a disease of childhood. It is very 



EDUCATIONAL HINTS. 209 

rare before the age of puberty. From that period to 
twenty-five it is more common ; and increases in fre- 
quency as life advances. 

The alarming fact has been placed beyond dispute 
that there is a steady increase in the insane population 
of this country as well as France and Great Britain, 
an increase more than proportionate to the sane popu- 
lation. The causes of this we must seek in the ex- 
treme mental tension required by the close struggle 
for money in modern life. "When this does not over- 
turn the intellect of the individual, it may implant the 
seeds of a perversion of faculties in his offspring. 
Then, too, the excessive overcrowding of the poorer 
population in the great cities, and the increase of un- 
healthful employments, lead to mental infirmity. 

When there is any suspicion of a tendency to in- 
sanity in a family, the parents should aim with un- 
swerving care at two points in the education of their 
children : first, to develop them to the utmost physical 
health; secondly, to lead their minds to a constant 
occupation with outward things, to sedulously prevent 
solitary contemplation, and all introverted mental ac- 
tivity. 

To accomplish these, the rules of hygiene in the 
training of children and youth should be carefully 
observed. The parental control should be exercised 
in a uniform, gentle, yet firm manner. The attention 
should be directed early to practical matters, all at- 
tempts at rapid acquisition of knowledge avoided, and 
every species of undue excitement of mind or body 
discountenanced. Politics, emotional religion, and 

14 



210 THE PREVENTION OF SPECIAL DISEASES. 

speculation send annually in this country hundreds 
upon hundreds of victims to the insane asylums. 
Violations of the passions of sex, as we have else- 
where shown, account for nearly one-sixth of their 
inmates. Over-work and under-feeding have also 
their quota. 

Calmness in passion, moderation in ambition, and 
life in action and not in thought and feeling, are the 
golden rules which must be obeyed. "I cannot but 
think," says Dr. Maudsley, the most eminent authority 
on the subject of insanity in Great Britain, u after 
what I have seen, that the extreme passion for getting 
rich, absorbing the whole energies of life, does predis- 
pose to mental degeneration in the offspring — either 
to moral defect, or to moral and intellectual deficiency, 
or to outbreaks of positive insanity." If father and 
son both follow out the dictates of this absorbing pas- 
sion, the results here pictured are far from rare. 

INSANITY FROM INDIGESTION. 

Regarding the physical health, perhaps no portion 
of the body requires more attention than the digestive 
organs. In a recent report of a State institution for 
the insane, we notice that the superintendent remarks 
that in observing the varied cases of insanity which 
come to asylums for treatment, quite a large proportion 
of them, nearly one-half of the whole number, have a 
morbid condition of the brain, which has been induced 
by dyspepsia long continued. Such cases are difficult 
to treat, require much care, and are not easily cured. 



DYSPEPSIA AND INSANITY. 211 

Early attention to the digestive organs by applying 
proper diet, and the use of the right kind of medicine, 
together with healthful exercise in the open air, with- 
out being carried to fatigue, would rescue many from 
the vortex of insanity into which their physical disease 
is fast plunging them. In such instances, any lurking 
hereditary mental taint is developed with fearful ra- 
pidity, and hence the vital importance of the timely 
and prompt correction of indigestion or incipient dys- 
pepsia. 

CHILDBED INSANITY. 

There is a variety of insanity, not very infrequent, 
which makes its appearance after childbirth in women. 
Investigation into family history often proves that 
this is the outcrop of a hereditary mental taint. 
"Where, therefore, there are any reasons to suspect the 
presence of such a liability, it is of importance to be 
extremely guarded during pregnancy, and at the time 
of sickness, that no violent shock or emotion is experi- 
enced, and that the labor be conducted to its termina- 
tion naturally and promptly. 

Those who dread an attack of insanity, or who suffer 
from a general disordered condition of the nervous 
system, with depression of spirits and sleeplessness, 
which may be the incipient stage of the disease, will 
act most wisely to enter a hospital or asylum devoted 
to the treatment of these diseases. 



212 THE PREVENTION OF SPECIAL DISEASES. 
INSANE ASYLUMS. 

"We wish at this point to correct a pernicious error 
which is abroad among the public. Some people 
honestly believe that sane persons are frequently, either 
from mistaken or from improper motives, placed in hos- 
pitals for the insane, and kept there against their will. 
We can most positively assure them that such an opin- 
ion is an utter error, fostered by sensational writers, 
who have no regard for truth, but only care to write 
striking articles. Such extreme caution is used by 
law in every commonwealth of the United States, 
that such an occurrence is next to impossible; and we 
believe it safe to say that not a half dozen instances 
are on record in this country where sane persons have 
been proven to have been unlawfully confined. 

Questions of much more importance to the public 
are, whether there is no loss in neglecting the care of 
those who have mental diseases, and whether there is 
no danger incurred from those thus affected not being 
sent to hospitals, or being left without proper attention 
and unrestrained in their movements. 

The first of these questions is readily answered, as 
all experience goes to show that, properly treated, 
insanity is, in its early stages, in a large proportion of 
all the cases, a curable disease, and that, allowed to 
become chronic, it is exactly the reverse. 

The second question may be answered by the simple 
statement of the fact — which can hardly have escaped 
the notice of any one who carefully observes passing 
events, and which can be readily verified — that during 



ADVANTAGES OF ASYLUMS. 213 

any year, in almost any newspaper, there are recorded 
nearly a hundred cases in which lives have been lost, 
or placed in the greatest jeopardy, owing to persons 
laboring under insanity being left unrestrained and 
unguarded in their movements. A large proportion 
of all these — far more than a majority — might have 
been saved, had the warnings which, to those familiar 
with such cases, were clear and unmistakable, been 
heeded: while the consequences of neglect are irre- 
parable and often destructive to the happiness of whole 
families. 

This simple statement of facts, without any allusion 
to the unfortunate effects upon entire households, 
from the continued presence of these cases, and the 
loss of property incident to incapacity for business 
management, is enough to show that this is no trifling 
question, and that a fearful responsibility is incurred 
by those who in any way contribute to this state of 
things. This subject certainly deserves much more 
attention than it receives, for while every supposed 
case of unnecessary restraint is abundantly commented 
on, these terrible catastrophes — without furnishing 
one or more of which scarcely a week passes — rarely 
receive more than a passing notice. 



EXAMPLES OF INSANITY. 

The exciting causes of insanity, which it is impera- 
tive upon those who have any tendency to it to avoid, 
are well illustrated in various plays of Shakespeare. 
In King Lear the feeble powers of an aged man are 



214 THE PREVENTION OF SPECIAL DISEASES. 

crushed by desertion, want, and ingratitude. The 
"fair Ophelia" forfeits her sanity to grief for a father's 
death and a lover's coldness; and Timon of Athens, 
through loss of fortune and friends. 

THE PREVENTION OE EPILEPSY. 

Epilepsy, or falling sickness, in about a third or more 
of the cases which occur, is a hereditary disease, and 
therefore, when either parent has been subject at any 
time in life to fits, it is of the highest importance that 
the children should be subjected to those rules of 
Hying least calculated to develop the tendency. 

Diet, here, stands foremost. A rich meat diet 
should be shunned, and plain food, wholly or nearly 
wholly vegetable, should be substituted. Sometimes 
this alone is sufficient not only to prevent but to cure 
the fits. Some physicians recommend that simple 
bread and water should be the staple articles, but we 
need not be this rigid. 

Another recommendation is, that every indigestible 
article shall be excluded, whether vegetable or not; 
that the amount of food taken be always moderate, 
and that the bowels should be kept perfectly regular. 
Instructions for this purpose will be given in our 
article on "Constipated Bowels." (See Index.) 

Children troubled with worms are liable from this 
cause to have the fits provoked, and therefore parents, 
who have reason to fear such a tendency, should watch 
closely, and at the appearance of those symptoms 
which indicate the presence of worms (to be described 



DIET EST EPILEPSY. 215 

hereafter) they should promptly administer an efficient 
vermifuge. 

At the period of puberty, when the system under- 
goes such profound changes, and is exposed to serious 
disturbances, epileptic fits are apt to develop them- 
selves. In our other works, the Physical Life of 
Woman, and the Transmission of Life, we have gone 
minutely into the hygiene of this epoch of life, and 
to these treatises we must refer our readers. 

Dr. Jackson, of Boston, relates the case of a young 
boy, who was brought to him for epilepsy. He gave 
him a purge, and the recommendation to eat only vege- 
table food, in moderate quantities, at regular hours 
(never between meals), and to keep his bowels open. 
The boy obeyed, and never had a fit but once after- 
wards, and that was once when he ate immoderately of 
green apples. This anecdote illustrates not only the 
efficacy of diet, but the danger of excess. 

As anger, over-fatigue, and excitement predispose 
to the fits, constant caution should be exercised in 
these respects. Indeed, the means of preventing 
epilepsy may be summed up in the advice to live a 
sober, temperate, regular life. The use of tobacco, 
alcoholic drinks, tea, and coffee should be done away 
with altogether. 



TO PREVENT DISEASE OF THE HEART. 

Medicine, which aims at reducing the amount of 
disease, is sometimes obliged to confess that all her 
efforts are vain. This is the case with heart diseases. 



216 THE PREVENTION OF SPECIAL DISEASES. 

They are unquestionably on the increase, and especially 
so in America. The explanation is that as a nation 
we live too fast, are exposed to too great excitements, 
to over-stimulation, to excessive and spasmodic exer- 
tion — all well-known causes of heart disease. Physi- 
cians have called attention to the fact that this increase 
is greatest in the large commercial marts, and in Cali- 
fornia and other new States, where the agony of com- 
petition is the keenest. 

The tendency to the disease must be combated by 
a deliberate renunciation of the causes which we have 
mentioned. Excitements must be shunned, and a calm 
and sober life chosen. To the predisposed, narcotics 
are, however, as bad as stimulants. Tea, coffee, and 
tobacco must not only be limited, but renounced. 
Exercises should be sought which impart strength to 
the extremities, but do not call for any very active 
exertion, and do not excite the action of the heart, such, 
for example, as the Indian clubs, the light dumb-bells, 
etc. Dancing, running, leaping, and swimming are 
injurious, if not dangerous. 

"When possible, a residence should be chosen on or 
near the seashore. An eminent English medical sta- 
tistician, Mr. Haviland, has conclusively shown that 
residents on the coast are decidedly less subject to 
this class of complaints than those dwelling inland. 



i 

THE PREVENTION OF GOUT. I. 

The hereditary predisposition to gout is so marked, i 
that it can be traced in fully half the cases the physi- 



REGIMEN AGAINST GOUT. 217 

cian is called upon to treat. The general nature of 
the disease is the reverse of that of consumption. In 
the latter, there is a want of nourishment; in the 
former, an excess of it; or, as Professor Niemeyer 
expresses it, there is a disproportionately large supply 
of food for the demands of the system. In fact, gout 
is a disease hardly ever seen in hospitals, because it is 
the penalty of the rich, the luxurious, and the gour- 
mand. 

But, when hereditary, ordinary moderation will not 
suffice to escape its visitation, and some additional 
precautions must be taken. The food should be 
largely vegetable; meat should be taken but once a 
day; spices must be used very moderately; and a set 
dinners" firmly declined. Alcoholic beverages of all 
kinds, whether malt, vinous, or spirituous, must be 
absolutely interdicted. They are poisonous to a gouty 
person. The same is true of tea and coffee. Although 
they do not furnish nourishment themselves, they aid 
to store up the nourishment in the system, which, in 
this complaint, is precisely what we wish to avoid. 
Drinking large quantities of water, on the contrary, 
should be cultivated. This hastens the discharge of 
effete matters, washes them out, as it were, and cleanses 
the system from matter which would otherwise clog 
its motions. Mineral waters which contain salt, and 
those which act as laxatives, are very appropriate. 
They reduce the plethora, which is usually present, 
and act very perceptibly on the general feelings. 

Not less essential is abundant and regular exercise. 
A lazy, do-nothing life is very certain to bring on the 



218 THE PREVENTION" OP SPECIAL DISEASES. 

disease years earlier than it would come, were the body 
actively employed. It is the more important that this 
warning should be heeded in time, for after one severe 
attack of gout, the individual never feels quite so able 
to undertake muscular exertion as previously. 

II. Diseases Incident to Certain Occupations. 

' In the crowded walks of daily life, where our wants 
are so imperative, our responsibilities so heavy, and 
competition so desperate, many a one is forced into 
methods of gaining a livelihood which are attended 
with special dangers to the health. Modern sanitary 
science, ever on the alert to guard the interests of 
humanity, has suggested many important measures 
which can reduce the unwholesomeness of various 
arts. We shall briefly give the fruits of such research, 
so far as they touch upon some of the more prominent 
occupations. 

The avocations of modern life may be considered 
as divided into those which demand mental labor, and 
those which demand physical labor. 

the dangers of mental labors. 

Although, at the first thought, these might not strike 
us as attended with any special dangers, they are in 
fact accompanied with peculiar and marked ones. 
As has been justly remarked by a distinguished 
London physician, "Our educated, ambitious, over- 
straining, untiring, mental workers are the breeders 



DISEASES OF MENTAL WORKERS. 219 

and intensifies of some of the worst forms of physical 
malady." 

The most distinct forms of these diseases are palsy, 
disease of the heart, and diabetes and other diseases 
of the kidneys. Physicians and lawyers are prone to 
affections of the kidneys and partial or general palsy. 
The latter gives warning of its approach by signs 
which, however marked, are often neglected by medi- 
cal men themselves. The most characteristic is a 
sensation on the part of the person threatened of 
necessity during any mental effort for frequent rest 
and sleep. When this condition exists, the slightest 
shock tells on the nerves, and transforms the im- 
pending malady into a dread reality. 

Dramatic artists, owing to the excitement attend- 
ant on their avocation, are very liable to heart disease, 
dyspepsia, and paralysis. 

The ardent business man and speculator, intent on 
his own schemes, full of anxieties, sinking all other 
considerations in the one great greed of gain, is very 
frequently interrupted in the midst of all his plans 
and projects by the gaunt finger of Disease, appearing 
as a sudden palsy, an insidious softening of the brain, 
or an actual outbreak of insanity. 

The clerk and book-keeper are free from the anxie- 
ties of large investments, and their employment is 
almost mechanical. The disorders arising from their 
occupation are confined chiefly to dyspepsia, piles, and 
general debility. 

The means of "prevention do not consist in idleness 
and mental vacuity. Far from it. It is well ascer- 



220 THE PREVENTION OF SPECIAL DISEASES. 

tained that mental work carried on with evenness and 
order, even hard mental work, so far from being harm- 
ful, is actually conducive to health and length of days. 
It is far healthier than mental inaction, or engagement 
in trivial and frivolous subjects. But the source of 
the evils, and that which under all circumstances is to 
be avoided, is extreme mental strain. No persistent 
and prolonged taxation, much beyond the usual degree, 
should ever be attempted. The desperation of busi- 
ness competition must be diminished. The terrible 
anxieties attendant upon great pecuniary risks must 
be avoided. The imperious demands of ambition 
must be modified. The engrossing troubles of pub- 
licity must be shunned. 

" Learn thy little bark to steer 
With the tide, and near the shore." 

Is it replied to this that we are asking impossi- 
bilities ? That the man once in the vortex of American 
business life can no more extricate himself than if he 
was in the rush of the Maelstrom? That these 
strains and anxieties are inseparable from all success, 
and even attempts at success? "We sadly feel the 
truth of much of this, but it does not in any way 
impeach the wisdom and the needfulness of our advice. 
Nature's laws are more inflexible than iron, they alter 
not, and he that disobeys them dashes himself against 
a wall. The frequency with which death, palsy, and 
insanity strike down our business men proves it only 
too conclusively. 



UNHEALTHY OCCUPATIONS. 221 

DISEASES INCIDENT TO INDOOR OCCUPATIONS. 

All persons whose occupations require them to pass 
their time indoors are more liable to consumption, 
scrofula, and low fevers than those who enjoy the 
benefits of a free and pure air. The disadvantages 
of indoor occupations can, however, be remedied, and 
in time will be when hygienic principles will prevail in 
the construction and furnishing of work-rooms and 
residences. Perfect ventilation, judicious warming, 
and complete sewerage are what are most needed in 
modern architecture, but it is sad to see how they are 
neglected in order to save a few dollars. 

WORKERS AMONO LEAD AND PAINT. 

These include a great variety of occupations, such 
as painters, glaziers, plumbers, color grinders, foundry 
men, many factory operatives, shot manufacturers, 
potters, etc. They are all exposed to the action of 
lead. 

This metal, so useful in the arts, is at the same 
time a dangerous and insidious poison. It creeps 
into the bodies of those who work in it, and destroys 
their health ; some feel its noxious effects quickly, 
others only after the lapse of years; but very few 
escape them. It is well known that its absorption 
leads to the complaint called "lead-colic" or "painters' 
colic," and also to that peculiar palsy of the arm 
known as "wrist drop." Many workers in it suffer 
from a sensation of weight and tightness in and around 



222 PREVENTION OF SPECIAL DISEASES. 

the chest ; all have more or less disrelish of food and 
imperfect digestion; and the end of many is by a 
general palsy, and kidney disease. Those who are 
poisoned by it have a dejected look, a sallow skin, a 
lagging walk, and if the edges of the gums be exam- 
ined, just where they join the teeth, a gray leaden line 
will be noticed. 

The treatment of this condition will not occupy us 
here, but its prevention. This can be accomplished by 
a rigid observance of the following rules: — 

All workers among lead should, before commencing 
or resuming their work, wash their hands, not once, 
but many times a day, in a strong decoction of oak- 
bark, which will protect against the action of lead. 

The hair of the workman should be kept short, as 
this prevents it from accumulating fine particles of 
lead. 

All painters should wear, during their work, clean 
cloth caps. All their clothes should be made of 
materials that can be easily washed. 

The workman's hands should always be washed 
before he touches his food; and, if they be stained 
with paint, they should be dipped into the oak-bark 
decoction. 

The mouth should always be well rinsed with cold 
water before food is taken. "We would suggest the 
use of a weak oak-bark decoction as a wash several 
times a week. 

The food should contain a large proportion of fatty 
substances. Milk should also be taken in large quan- 



TO ESCAPE LEAD-POISONING. 223 

titles. It counteracts to an extraordinary degree the 
poison from lead. 

The body should be sponged night and morning 
with cold or tepid water, and the hair should be 
washed thoroughly every evening after work. 

"When men or women are exposed occasionally to 
the fumes of lead, folded muslin, or a handkerchief, 
should be placed over the mouth; the outer layer of 
the band having been previously soaked with oak-bark 
decoction, and then wrung out. 

Employers and foremen should see that facilities to 
carry out these directions are given their employes, 
as by their rigid observance the danger from the 
metal is almost entirely obviated. The fumes and 
bad air of the establishment should be carried up a 
special ventilating shaft, worked by a fan. "White- 
lead should always be ground under water as is now 
done in many large mills. 

To counterbalance these evils, it is generally and 
probably correctly believed that workers in lead are 
not so liable to consumption as other indoor laborers. 

WORKERS IN COPPER. 

Those employed in working this metal usually have 
distinctly marked green stains on the teeth, and even 
greenish hair. Although an unhealthy-looking class 
of men, and not long-lived, they seem subject to no 
particular disease except general debility, or a weak- 
ness of the whole muscular powei s. It is a remark- 
able fact, on the other hand, that they escape almost 



224 PREVENTION OE SPECIAL DISEASES. 

entirely attacks of cholera, or cholera-like seizures, 
when those diseases are epidemic around them. 



WORKERS IN PHOSPHORUS. 

These are liable to most severe and terrible dis- 
eases of the bones, brought on by inhaling the fumes 
of the substance; especially the jaw-bones become 
affected, and occasionally have to be removed. Ope- 
ratives in lucifer match manufactories, and in the 
preparation of the commercial article, are the principal 
sufferers. 

Fortunately, modern science has discovered a 
simple, handy, and cheap antidote to these baneful 
effects. It is to wear a sponge over the mouth and 
nose, which has been dampened with ordinary spirits 
of turpentine. This entirely neutralizes the poisonous 
action of the phosphorus. 

WORKERS IN IRON. 

Though there is nothing poisonous in this metal, the 
operatives in nail factories and other iron works, where 
the air is loaded w^ith particles of the metal in im- 
palpable powder, are known to be generally short-lived. 
Many of them are carried off while still young by the 
disease known as "nailers' consumption," a form of 
chronic pneumonia. Their health also suffers from 
the alternation of heat and cold to which they are 
exposed, the furnaces being usually located in open or 
partially open sheds, and the smelters working either 



potters' asthma. 225 

naked to the waist, or with loose shirts. The use of 
•j respirators, and heavy flannel shirts, will obviate most 
of these dangers. 



DISEASES OE POTTERS. 

Potters are subject to what is called "potters' 
asthma," which is a variety of consumption of the 
lungs, and which carries many of them off in middle 
life. It is caused by the dust and gases in the atmos- 
phere of potteries, and is not dissimilar from the other 
diseases caused by the same agents in other trades; for, 
as Dr. GSreenhow observes, " the nature of the sub- 
stance inhaled appears to be of secondary consequence 
as regards the ultimate result, excepting that the 
heavier and more penetrating kinds of dust, such as 
angular parts of grit, more speedily excite serious 
disease than the lighter kinds." 

To ascribe to these diseases their direct causes is 
not a difficult task; these are the inhalation of 
mechanical and chemical irritants, an over-heated 
atmosphere, and a deficient supply of oxygen. 

"Potters' asthma" is a dangerous disease. It com- 
mences with a "bad cough," and will in a few years 
prove fatal unless the employment is given up be- 
times, in which case it usually disappears with ordi- 
nary attention to the general health. 



15 



226 PREVENTION OE SPECIAL DISEASES. 

III. Contagious Diseases. 

HOW TO AVOID CONTAGIOUS DISEASES IN GENERAL. 

Physicians have given much attention to the ques- 
tion how diseases are extended. Their conclusions 
deserve close attention, for upon them, of course, 
depends the nature of the precautions we should 
adopt to avoid contracting maladies. "We shall briefly- 
state what they are, carefully avoiding technicalities 
and vexed questions. 

CONTAGIOUS DISEASES. 

Contagious diseases are those which can be commu- 
nicated by the touch or immediate presence of the 
patient himself, or from some material derived from 
him ; such, for example, as smallpox, scarlet fever, and 
typhus fever. Infectious diseases are those produced 
by some poisonous matter in the atmosphere, which is 
not produced or increased by the human body; of this 
class are ague, typhoid fever, etc. 

It will readily be seen that, in diseases of the former 
class, our cares should be directed to avoid unneces- 
sary contact with the sick, to take all possible precau- 
tions that they do not unnecessarily communicate 
with others, and to destroy as much as possible what- 
ever poisonous matter they create. In those of the 
latter class, many such precautions are useless and 
needless, and our attempts should be pointed to chang- 
ing the character of the surrounding atmosphere by 



IMPORTANT SUGGESTIONS. 227 

enforcing stricter sanitary regulations. Both these 
aims can be attained in great measure. 



HOW TO AVOID CATCHING A DISEASE. 

Whenever we have occasion to visit a person sick 
with a contagious disease — and it becomes the duty 
of every one to do so some time or other — no excessive 
fears should be allowed to take possession of the mind. 
In the first place, they are needless and unmanly, and, 
secondly, they actually predispose the system by 
lowering its tone, to become an easy prey to the enemy 
so much dreaded. Shortly before entering the house, 
or the room, something should be eaten or drank, as 
when the stomach is active the contagious poison is in 
a measure repelled. Hence, after a meal, is a good 
hour to choose. We have known physicians to carry 
with them crackers, and take a few mouthful s before 
entering the room of patients with such diseases. 
The plan is a good one. 

Some believe that the poison of a sick-room is con- 
veyed to the system through the spittle, which first 
comes in contact with the impure air in the mouth, 
and is then swallowed. It is well, therefore, to eject 
and not to swallow it, when so exposed. 

Cleanliness of the person tends to prevent contagion, 
therefore those exposed should bathe morning and 
evening, and change their clothing daily. 

Immediately, on leaving the sick-room, a brisk walk 
of a fourth of a mile or so will thoroughly air the 
clothing and excite the nervous forces to throw off the 



228 PREVENTION OF SPECIAL DISEASES. 

poison. The latter may also be accomplished by the 
use of a stimulating draught, as, for instance, one com- 
posed of ten grains of carbonate of ammonia in a 
wine-glass of water. The use of alcoholic stimulants 
for this purpose, so popular in many localities, is to be 
condemned. They leave the system in a state of pros- 
tration, which not merely exposes it the more readily 
to the poison of contagion, but leaves it the less able 
to offer resistance. Strict abstinence is always to be 
enjoined. 

It is not well to sleep in a room with a patient with a 
contagious disease. Hence, when called upon to watch 
a night with the sick — which every humane person is 
willing to do — it is more prudent to take a book and 
keep awake the whole night. "When asleep, the sys- 
tem is relaxed, and offers less resistance to contagion. 

The odors of vinegar, of camphor, of hartshorn, 
and many other substances, have, at times, enjoyed 
some reputation as preventives of contagious poison. 
Modern chemical science has overturned most of these 
beliefs, and branded them as popular delusions. To 
make amends for this ruthless destruction of pleasant 
and harmless fancies, however, it has brought forward 
a class of agents which depend for their reputed efficacy 
not on the imagination of the populace, but on a wide 
experience of scientific men. They are called disin- 
fectants. 

THE USE OF DISINFECTANTS. 

These substances claim from us, in this connection, 
a special attention. 



THE BEST DISINFECTANT. 229 

Many of them have been prominently brought 
before the public of late years, but not all of them 
deserve the praises which the advertisements bestow 
on them. It would be of no advantage to our readers 
to rehearse their comparative meiits, so we shall men- 
tion only a few which combine the advantages of 
being the cheapest, the most efficacious, and the sim- 
plest. 

First and foremost, as unquestionably the best of 
all, we place 

CARBOLIC ACID. 

This is a liquid prepared from coal tar, without 
color, and of a strong, smoky, penetrating odor, like 
creasote. It possesses the power of destroying nearly 
all forms of minute life, and is most distasteful to 
vermin of every description. No moth or mosquito 
will enter a room which is scented with it; no bedbug 
will remain in a bed which has been sprinkled with it; 
and rats and roaches vacate their haunts which have 
been dampened with it. Meat, exposed to its vapor, 
does not rot, but shrivels and dries up. Rubbed up 
with lard and used as an ointment, it is a sovereign 
remedy for fleas, lice, and itch on the lower animals. 
And it seems to act with not less power on the mys- 
terious contagious poisons thrown out by persons with 
communicable diseases. Their rooms, clothing, beds, 
and discharges should be exposed to its action, when 
the odor is not unpleasant to them. 

Unfortunately this is the case in very many in- 
stances, and as the smell is very permanent, it is im- 



230 PREVENTION OF SPECIAL DISEASES. 

possible to use it very freely in the house. To purify 
privy- wells, sewers, sinks, hog-pens, and similar places, 
there is nothing superior. 

The common impure carbolic acid is cheap, and can 
be mixed with water in the proportions of an ounce 
of acid to a gallon of water for ordinary sprinkling 
purposes. 

Cresylic acid is a very similar preparation, and one 
which has the same properties. 

Next to carbolic acid, we rank as a disinfectant 

PERMANGANATE OF POTASH. 

This substance comes in a solid form, in beautiful 
dark crimson crystals, and when dissolved in water 
forms a rich, claret-colored solution. Half an ounce, 
or about a tablespoonful, dissolved in a gallon of water, 
forms an excellent disinfecting fluid. It has no dis- 
agreeable odor, and the only objection to its use is 
that it stains the linens, etc. For a wash to foul 
wounds, and to place in shallow saucers in the corners 
of rooms where the sick are present, it is well adapted. 
Cellars which have an unpleasant odor, musty closets, 
and close rooms should be purified in this manner. 

SULPHATE OF IRON, 

"Which is familiar to all under its common names of 
copperas and green vitriol, is one of the best of disin- 
fectants, and a cheap one also. It can be either dis- 
solved in water, or mingled with lime and powdered. 



SULPHUR FUMIGATION. 231 

If dissolved, the liquid should be used at once and 
not kept on hand, as it forfeits a part of its strength 
on exposure to the air. 

SULPHUR 

Is another handy and valuable substance for this pur- 
pose. It has some peculiar advantages where we wish 
to disinfect a person, a carriage, closet, etc., by fumi- 
gation. A " ready method" of doing this has recently 
been recommended in the English journals, which 
deserves to be generally known. In the case of dis- 
infecting beds and bedding, five to fifteen minutes 
before the patient enters the bed, or during his removal 
whilst it is made, a copper warming-pan, containing 
a few live embers, on which a teaspoonful or two of 
flowers of sulphur have been thrown, is to be intro- 
duced between the sheets, and passed to and fro until 
the combustion of the sulphur is completed, when the 
pan is to be withdrawn ; and, after a lapse of a few 
minutes, the patient may enter the bed, when, should 
the fumes still prove too stimulating for him to breathe, 
these vapors may be intercepted by holding a loosely 
folded damp handkerchief before the nose and mouth 
until they have subsided. In localities where a copper 
warming-pan is not procurable, a common wicker 
handbasket, or a small hamper, containing an old iron 
saucepan or flower-pot, or basin, in which a few hot 
cinders have been placed, may be substituted. This, 
like the warming-pan, must be put beneath the bed- 
clothes, and moved about during the burning of the 



232 PREVENTION OE SPECIAL DISEASES. 

sulphur, until the gas has sufficiently permeated the 
linen, etc., to be disinfected. 

It will be perceived that this latter plan of using 
the sulphur may be adapted to fumigating closets, 
carriages, passages, and, indeed, to the vacated 
chambers of the sick; the only precautions to be 
borne in mind being to take care that the quantity of 
sulphur or heat of the live embers be not too consid- 
erable, and that the wicker work is of sufficient height 
and capacity to prevent the articles fumigated from 
being burnt in the operation. 

With regard to disinfecting the clothing, articles 
of dress, etc., these should be lightly sponged over or 
sprinkled with water containing a little well mingled 
milk of sulphur, in the proportion of a teaspoonful of 
sulphur to each pint of water. The articles should be 
then ironed by means of a flatiron heated to a suffi- 
cient temperature to volatilize the sulphur, but not to 
burn the clothing. Of course repetitions of this 
process will be required, according to the extent and 
duration of the infection. 

Finally, we may mention that where none of these 
articles can conveniently be had, nature has provided 
three excellent disinfectants, which are always and 
everywhere at hand, and which are cheap enough to 
be within the reach of the very poorest. They are 
fresh wood charcoal, quicklime, and fresh earth. 

In the last mentioned substance nature has provided 
in unlimited quantities, and within the reach of the 
poorest, one of the very test of disinfectants, and we 
call special attention therefore to the value of 



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The Eaeth-Closet. 



THE VALUE OF FRESH EARTH. 233 



THE EARTH-CLOSET. 

From the most ancient times it has been customary 
to cover dead bodies and offensive matter with earth, 
but only within a few years past has it been clearly 
recognized that this not only conceals them, but renders 
them innoxious to the health, and deprives them of 
odor. We now know that a proper quantity of ordi- 
nary earth — not sand or gravel, but loam — dried and 
sifted, will, when mingled with any foul substance, 
such as the passages of men or animals, entirely cor- 
rect their odor, and remove their poisonous qualities. 

This fact can be utilized in the arrangement of pri- 
vies, and the disinfection of sinks and wells. If each 
stool be immediately covered with about a pint of fine 
dry earth, all disagreeable smell is at once destroyed, 
and so completely that it may be left in one's sleeping 
apartment for days without annoyance. In a closet 
used by a number of persons, a box of this sifted earth 
should be kept near the seat, with a scoop, so that each 
can, after using the closet, throw a scoop of earth upon 
the dejection. When the vault is full, the contents 
can be removed without causing any disagreeable 
stench. 

The dry earth-closet is especially valuable in the 
chambers of invalids, and in those houses which have 
no water-closets in them. It is far preferable, both for 
comfort and safety, to any other commode invented. 
The following simple and cheap plan of constructing 
one is quoted from a late pamphlet on the subject : — 

A board box, of convenient size, not less than 



234 PREVENTION OF SPECIAL DISEASES. 

eighteen inches deep, may be fitted with a movable or 
hinged cover, with an ordinary finished hole. Unless 
the box is water-tight, its joints should be filled with 
putty, white-lead, tar, or pitch. Three inches of dry 
earth should be spread upon the bottom. At its side 
there should stand a box of sifted dry earth or coal- 
ashes, with a small tin scoop or cup. After each use 
of the closet, enough earth should be thrown into the 
box to simply cover the feces. A pint of earth is 
ample for the purpose. When this box is filled, its 
contents may be removed with a shovel and corn-bas- 
ket, and it may be kept in the bedroom with as little 
offence as the stove or chest of drawers. 

Suitable earth for the purpose can be obtained in any 
quantity by collecting the dust in the road when, for 
some time, the weather has been dry. 

GENERAL PRECAUTIONS. 

The attendants on the sick with any communicable or 
any disagreeable disease should place about the room 
lumps of charcoal; cellars, cesspools, and outhouses 
should be freely sprinkled with quicklime; and foul 
matters should be covered with fresh earth. Such 
precautions will greatly lessen the danger of the 
disease extending. 

"When there is no sickness in a house, it is always 
well to throw some quicklime in the passages and 
cellars, and to purify rigidly and frequently every 
close and foul place about with this or some of the 
other disinfectants we have mentioned. "We urge this 



AIM OF MODERN SCIENCE. 235 

precaution with utmost earnestness, as we feel con- 
vinced that by the constant and universal observance 
of it a vast amount of illness and a large number of 
deaths could be prevented. 

It is rather by these general means, than by indi- 
vidual protection, that epidemics must be prevented. 
The science of a century or two ago was absorbed in 
the discovery of some specific which would shield the 
individual from contagion ; the science of to-day, less 
selfish, wider in its philanthropy, and with juster 
views of man's duty, rather searches for and recom- 
mends the means which will prove availing to guard 
the community from these misfortunes. 



IV. Special Contagious Diseases. 

THE PREVENTION OF SCARLET FEVER. 

There is no one of the maladies usually called 
"children's diseases" which is more fatal, which 
annually carries off more persons, which leaves more 
deplorable after-effects, and which is attended with 
more suffering, than scarlet fever. It is of the utmost 
importance, therefore, that those exposed to it should 
be made acquainted with the best means of avoiding 
its contagion, that those who have the care of cases 
should learn the precautions requisite to prevent its 
spread, and that convalescing patients should know 
how soon after the disease they can with safety asso- 
ciate with other people. 

The disease is extremely contagious, none, pro- 



236 PREVENTION OF SPECIAL DISEASES. 

bably, more so. The reason why it is called a disease 
of children, is, that it is so prevalent and its contagion 
so certain, that most persons who can contract it under 
any circumstances, do so in their childhood. 

A person who has never had it should avoid as 
much as is consistent with duty any exposure to it. 
"When necessarily brought in contact with those 
suffering from it, it is well to subdue all alarm and 
anxiety about contracting it, to keep the mind cheer- 
ful, to obtain a full amount* of sleep, to change the 
clothing frequently, to eat as much as the appetite 
demands, and to observe scrupulous cleanliness of the 
whole person. 

BY DRUGS. 

Several drugs have been lauded from time to time 
as preventives of scarlet fever. The most highly 
esteemed for a long while was belladonna. It was 
asserted that when taken in small doses — two or three 
drops of the tincture two or three times a day — it 
acted as a complete safeguard. The discussion as to 
the truth of this has occupied many volumes in 
medical literature, statistics on the one side having 
been met with equally convincing ones on the other. 
For ourselves, we frankly confess that we have no 
faith whatever in this pretended virtue of belladonna, 
and consider that the evidence is altogether against 
its efficiency. 

Quinine, the familiar principle of Peruvian bark, has 
found friends who maintain that it possesses similar 
powers. Inasmuch as it is an excellent tonic, it may 



TO PREVENT SCARLET FEVER. 237 

well brace up the system to withstand the attacks of 
contagion, but probably it exerts no such specific in- 
fluence in the disease under consideration as it does 
in fever and ague. 

A more potent preventive, we believe, has been 
found in the chemical drugs known as "bisulphites" 
of magnesia or soda. Several English physicians have 
reported that, administered in doses of a scruple three 
times a day, they either prevent the disease altogether 
or materially diminish its violence. "We have given 
them ourselves in a number of cases with similar re- 
sults, which we attribute to their power of neutralizing 
contagion. Unfortunately, they have an unpleasant 
sulphurous taste, which makes them repulsive to many, 
and must limit their use. This can, to a degree, be 
concealed by a judicious amount of some flavoring 
material, as in the following receipt : — 



Take of— 

Bisulphite of magnesia, five drachms, 
Essence of peppermint, a teaspoonful, 
Water, a tumblerful. Mix. 

Take a tablespoonful, in water, three times a day. 



Very recently, that familiar substance, tar, has been 
strongly recommended as a preventive not only of 
scarlet fever, but also of smallpox and typhus fever. 
This belief is not new. There was a work published 
in 1774, under the title of "Siris," by Bishop Berkeley, 
on the use of tar-water in arresting the progress of an 
epidemic of smallpox that occurred in his lordship's 
diocese. 



238 THE PREVENTION OP SPECIAL DISEASES. 

"Within a year, Dr. John Wetherfield, of London, 
has tried this preventive in a number of instances 
with marked success. He has no intention, of course, 
of advocating the use of tar-water in opposition to 
vaccination, which is without doubt the best antidote 
to smallpox; but he considers tar to be useful in pre- 
venting the spread of scarlatina and typhus. He 
administers it in the form of pills, made by adding 
powdered charcoal with mucilage to the tar — the finest 
Stockholm variety being the best for the purpose. 

The use of this, though not intended as a remedy after the 
disease has been contracted, has, in Dr. Wetherfield's expe- 
rience, when regularly taken, prevented the spread of typhus 
fever in families where one or two members have been attacked 
before the tar was tried. After the pills were fairly in use, no 
other person, however much exposed to infection, has taken 
the disease. Subjoined are a few scarlet fever cases out of the 
many in whiph the plan is said to have been successfully tried. 
In no instance were the children or other members of the 
families sent away out of the infected houses: — 

The family of Mr. P , twelve children and servants. 

One only attacked. The remainder took the pills very regu- 
larly, and escaped. 

Mrs. P , a widow, with two children, all sleeping in the 

same bed. Only one attacked. 

Dr. P , eleven in family. One child had died before the 

preventive was tried, and two others were suffering under 
the disease when it was commenced. No other was attacked ; 
but the tar was taken by all regularly. 

Sweet spirits of nitre, in doses of twenty drops to 
a teaspoonful twice a day, is also useful as a preven- 
tive remedy. 

The precautions to prevent its spreading are pecu- 
liarly valuable in public institutions, schools, board- 



TO PREVENT SCARLET FEVER. 239 

ing-houses, and large families. They should be fami- 
liar to all, and rigidly carried out. 



BY SANITARY PRECAUTIONS. 

A sufferer from scarlet fever for a period of about a 
month from the beginning of the disease is continually 
throwing off from his body a poison which has the 
power of conveying the disease to others. The poison 
is chiefly contained in the scales which are thrown off 
from the skin, but is also in the discharges from the 
throat and nose, and from the bowels and kidneys. 

Taking these facts as the basis of our precautionary 
measures, we must adopt the most efficient means to 
limit and destroy the poisonous emanations. The 
sufferer from the disease should be placed in a room 
as remote as possible from other inhabited rooms, and 
preferably in the upper part of the house. The room 
should have an open fireplace, in which a fire should 
be kept burning night and day. Ventilation should 
further be secured by a carefully regulated opening of 
the windows. 

The chamber should be cleared of all needless arti- 
cles of dress, carpets, curtains, draperies, etc., as they 
absorb and retain the poison. A nurse should be 
chosen who has already had one attack, as it rarely 
occurs twice in the same individual. She should have 
the least possible communication with the other in- 
mates of the house, and should wear a glazed cotton 
dress, which can readily be washed or disinfected. 

As all the discharges from the patient are poison- 



240 THE PREVESTTKOT OF SPECIAL DISEASES. 

ous, they should at once be disinfected or destroyed. 
In place of pocket-handkerchiefs, bits of clean rag 
should be used to wipe the mouth and nose, and when 
once used should be immediately burned. Discharges 
from the bowels or kidneys should be received in a 
vessel containing carbolic acid, or some other powerful 
disinfectant. All glasses, cups, or other utensils used 
by the patient should be carefully cleaned before being 
used by others. The nurse should frequently wash 
her hands with carbolic acid soap. The patient's bed 
and body linen should be immersed immediately on 
its removal in boiling water, and then in water con- 
taining carbolic acid, and .the laundress should be 
charged not to wash it with the other clothes. 

Wherever the slops from the sick-room are thrown, 
there should be a liberal down-pouring of carbolic 
acid, dry earth, or some other disinfectant. Care 
should be taken that there is no leakage from the 
drains, or sewer gas escaping in the house. 

As soon as the skin begins to come off in small 
scales, the whole body should be thoroughly rubbed 
twice a day with olive oil ; and a warm bath should be 
taken every other day. A little camphor may be added 
to the oil if agreeable. 

"When the disease is over, the bedding and clothing 
of the patient and his attendants, the floors, the walls, 
and the ceiling of his room, the surface of the furniture, 
and the interior of cupboards, drawers, and closets, 
must be thoroughly cleansed and disinfected. If the 
walls are papered, the paper should be removed and 
burnt, the ceiling whitewashed, and the floor scrubbed 



VACCINATION AND KEVACCINATTOK. 241 

with soap and carbolic acid. The room should then 
be left for a time unoccupied, with the windows open. 
These precautions may seem tediously minute and 
excessive, but they are all necessary. So permanent 
and virulent is the poison, that an instance is related 
where a girl picked out of a drawer and tied round 
her neck a silk band that a year before had been worn 
by a child with scarlet fever. In a few days the 
girl was seized with the disease, having undoubtedly 
contracted it from the ribbon. This illustrates how 
subtle is the poison. 

TO AVOID SMALLPOX. 

If the science of medicine were called upon to 
substantiate its claims to the respect and thanks of 
mankind, it has but to point to the wonderful and 
beneficent discovery of vaccination. A century ago 
there was not a disease more dreaded, and wnth 
greater reason, than smallpox. The mortality from it 
was frightful ; and the few who recovered bore the 
unsightly traces of their terrible illness to the grave. 

This is all changed now. "We can positively assert 
that if the public choose, there need be no more cases 
of smallpox — it may become an unknown and obsolete 
disease. This is to be effected by the universal, early, 
and obligatory resort to vaccination and revaccination. 
The protection which this little operation, so well 
known that we need not explain it, affords, is com- 
plete. 

It should be performed for the first time when the 

16 



242 THE PREVENTION OP SPECIAL DISEASES. 

infant is but a few months old, and repeated at least 
once, about the age of ten or twelve. 

A lighter form of the disease, known as varioloid, 
may be contracted after vaccination, and therefore 
revaccination is of essential importance. 

VACCINATION. 

There is no fact better established in the history of 
science than the protective power of vaccination ; and 
there is no disease more loathsome and repulsive than 
smallpox. Yet, with the full knowledge of these 
facts, persons are so negligent, or so blind to their 
own safety and that of their children, that they in 
repeated instances overlook this simple duty. It 
should, therefore, be placed within the power of every 
one to procure vaccine matter and to use it upon 
themselves. This, we are happy to say, has been done 
in at least one of the States — West Virginia — by the 
appointment of a State Vaccine Agent, whose duty it 
is to supply to every citizen of the State vaccine 
matter when requested, with directions for its use. 
"We have before us the circular of Dr. John C. Hupp, 
the State Vaccine Agent, and we cannot do better 
than to imitate his directions : — 



HOW TO PREPARE THE PATIENT. 

Make five or six parallel scratches with the point of 
a sewing-needle or a lancet at the point chosen for in- 
troducing the vaccine matter (which as a rule is about 



HOW TO VACCINATE. 243 

half-way between the elbow and the shoulder, on the 
outer side of the left arm), then cross them at right 
angles with similar scratches. The surface should 
present a slight blush with a very few specks of 
blood. Do not apply the matter until the bleeding 
has ceased, nor until all blood is carefully wiped 
from the scratched surface, as otherwise the vaccine 
matter may be washed away. 

HOW TO PREP ABE THE VACCINE MATTER. 

Scrape a small portion of the scab with a clean 
knife, on the bottom of a china cup or tumbler, and 
mix it into a thin paste with a little pure cool water. 

HOW TO APPLY THE VIRUS. 

Stretch the skin gently where the scratches have 
.been made, so as to open them, and then take one drop 
of the virus, prepared as above, and smear it over the 
part. Allow it to dry, being careful that it is not 
rubbed off by the clothing. This completes the 
operation. 

It should begin to inflame about the sixth or seventh 
day, and about the sixteenth the scale is ready to fall 
off. This it should be allowed to do, and never be torn 
off. "When removed, dry it carefully in a moderate 
warmth, and place it between two thin layers of wax 
about the size of a dime, and press them around it. 
This preserves it from the air, and it can be used on 
future occasions. 



244 THE PREVENTION OF SPECIAL DISEASES. 
PREJUDICE AGAINST VACCINATION. 

A foolish and dangerous prejudice possesses some 
people on the subject of vaccination. They fancy 
diseases are conveyed by the vaccine matter, and 
every illness that the infant has for a year after the 
operation is, if possible, attributed to it. This is folly 
of the worst description. There are no diseases propa- 
gated by vaccine matter; the operation never leaves 
any serious consequences ; and the very few instances 
which may be quoted to the contrary, are nearly al- 
ways to be explained by other causes. For ourselves, 
we believe the laws should heavily fine any one who 
neglects the discharge of this important duty to the 
public as well as himself. 

REVACCINATION 

Cannot be too strongly urged. Some people think 
that if vaccinated in infancy, this will protect them all 
their lives. This is not so. Many examples are on 
record where severe attacks of smallpox have appeared 
in such persons. The question is often asked : " How 
often should one be vaccinated?" We reply, when- 
ever smallpox is in the neighborhood, and, at any rate, 
not less frequently than once in ten years. The pre- 
caution is so simple and so important, that its neglect 
is inexcusable. 

When it does not " take," it may be owing to a loss 
of strength in the scab, or carelessness on applying it, 
dangers which should carefully be guarded against. 



THE CROWD POISON. 245 

TO PREVENT TYPHUS AND TYPHOID FEVERS. 

These diseases, which for a long time were supposed 
to be forms of the same, probably arise from different 
cause, and are produced by different poison. This 
poison, in the case of the former, strange to say, is 
man himself! That healthy people can evolve a 
poison fatal to their kind, is indeed a strange fact, yet 
one we cannot doubt. It is called the " crowd poison," 
for it is most virulent and powerful where many 
people are crowded together in insufficient space. 
Their breath and the emanations from their bodies 
cause a foul air which acts poisonously upon the 
system, and produces the diseases we have mentioned. 

TYPHUS FEVER 

Is the scientific name for what is otherwise called 
jail fever, ship fever, famine fever, spotted fever, and 
camp fever, all originating where dirty, half-fed, 
negligent people are huddled together. But it does 
not confine its ravages to them. On the contrary, it 
is contagious in the highest degree, and nurses, phy- 
sicians, visitors, and neighbors, no matter how cleanly 
and well fed, may fall victims to it. Judges sitting 
on the bench have caught it from the criminals brought 
before them ; benevolent Christians, visiting the poor, 
have fallen sacrifices to their sense of duty. 

Its outbreak can be prevented with certainty by 
constant attention to food, ventilation, and cleanliness. 
A century ago there was hardly a common jail in 



246 THE PREVENTION OF SPECIAL DISEASES. 

Europe where it did not prevail. Owing to the un- 
selfish labors of Howard, and other philanthropists, 
now hardly any of them are afflicted by it except 
under occasional circumstances. 

The contagion can be prevented by frequently air- 
ing the bedding and clothing, taking a sufficient 
quantity of good food, observing personal cleanliness, 
avoiding ill-ventilated apartments, and not crowding 
many persons into small space. 

When it has once broken out, these precautions will 
not suffice. The disease may be carried, like measles, 
scarlet fever, and smallpox, by persons who are not 
themselves affected. Neither sex escapes, and no age 
except the very old and the very young. Those worn 
out with over-exertion are more disposed to it than 
the vigorous, but even these do not escape. 

As a person who has once had the disease is not 
liable to a second attack, such a person should be 
chosen for a nurse. The patient should be separated 
from others, in an upper well-ventilated room, the 
discharges received into vessels containing some 
powerful disinfectant, such as chloride of zinc or 
carbolic acid, the soiled linen burned or soaked in 
water containing carbolic acid, the patient not allowed 
to associate with others until entirely well, and the 
room thoroughly purified after he has left it. 

The famous "plagues," which, from time to time, 
ravaged Europe during the Middle Ages, were, for the 
most part, forms of typhus fever. In the year 1665, 
London lost 65,000 souls, about one-third of its inha- 



THE VINEGAR OF THE FOUR ROBBERS. 247 

bitants, by such a scourge. Dauiel De Foe has left a 
most thrilling account of the terror it inspired. 

Another writer, equally famous, the Italian Bocaccio, 
has described in equally forcible language the fearful 
pestilence, of a similar nature, which, in his day, deci- 
mated Florence. 

As medical art could do little to heal those already 
sick, great attention was paid to the discovery of some 
specific which would prevent one from taking the dis- 
ease. Many such were devised by unscrupulous char- 
latans, and loudly vaunted for purposes of sale, but we 
are sorry to say, that, except by removing the fear of 
the disease, none of them really possessed any efficacy. 

One of the most famous, and perhaps the only one 
which has survived to this day, has the singular name, 
"the vinegar of the four robbers" (yinaigre des quatre 
voleurs). The story was that during one of the plagues 
of Marseilles, when half the population had fled or 
had died, four robbers accumulated a vast booty by 
plundering the dead and dying, and breaking into in- 
fected houses where none durst follow them. At last, 
one of them was arrested, and disclosed the means by 
which they secured such immunity from the pestilence. 
The recipe was made public property. It is composed 
as follows : — 

Thieves 1 Vinegar. 



Take of— 

Rosemary and sage, of each four ounces. 
Lavender and rue, of each, two ounces. 
Camphor and garlic, of each one ounce. 
Wine vinegar, one gallon. 



248 THE PREVENTION OF SPECIAL DISEASES. 

But whether it is that it is good for thieves only, or 
whether those ingredients have lost their virtue, 
certainly he who reposes on its protective power now- 
adays, will be likely to be disappointed. 

In fact, as before stated, there is absolutely no 
known specific to escape the contagion of the disease. 

TYPHOID FEVER 

Is far more common nowadays than typhus. It is 
more prevalent in winter than in summer, and in 
country places than in cities; the middle-aged and 
youth are the most subject to its attack. It is much 
less contagious than typhus fever, and in hospital 
wards it is not thought necessary to separate those 
sick with it from the other patients. Nevertheless, it 
is better in schools and public institutions always to 
place these cases in separate rooms, and observe the 
same precautions in their management as in typhus. 

Many instances are observed where a number of 
scholars in a school, or several members of the same 
family, and their nurses and attendants, sicken with it 
one after another. "When this occurs, it must not be 
supposed that they have caught it from each other. 
They have all been exposed to the same noxious poi- 
son, and this, and not contagion, is the explanation. 

The causes of such a visitation can generally be dis- 
covered. Sometimes it is a long exposure to bad air 
from want of ventilation; sometimes the air from a 
sewer or a privy- well entering the house; sometimes 
the floor and joists of the ground floor will be found 



THE SOURCES OF TYPHOID EEYEK. 249 

decaying and emitting a foul odor; stagnant pools of 
waste water may be close by; or a well in the cellar 
may prove to be in bad order. All such defects must 
be assiduously remedied, before exemption can be 
hoped for. 

Curtains, thick carpets, and heavy hangings gradu- 
ally absorb the exhalations of residents in rooms in 
winter, and become sources of the disease. They 
should be frequently beaten, brushed, and aired, and 
the sunlight allowed to fall upon them. The neglect 
of these rules in winter is why the disease is more 
prevalent in the winter than the summer season. 

A not unfrequent cause of typhoid fever has been 
ascertained within the last few years, and should be 
generally known. It is the use of cast-iron stoves for 
heating purposes. Experiments show that they throw 
off, when heated, a gas which is detrimental to the 
health, and the direct producer of typhoid fever. They 
should never be used in schools and lyceums, in public 
assemblages, nor even in private families. 

The Massachusetts Board of Health has lately given 
particular care to the determination of the cause of 
typhoid fever, and the results of its investigations 
deserve to be generally known. In all instances their 
inquiries led to the conclusion that the decomposition 
of organized, especially vegetable, matter was the main 
cause of the disease. Sometimes it was the drinking 
water made foul by human excrement, sink drains, or 
soiled clothing ; or the air vitiated by the emanations 
of drains, decaying vegetables or fish, or old timber, 
or by pig-sties, drained ponds, stagnant water, or aceu- 



250 THE PREVENTION OF SPECIAL DISEASES. 

mulations of filth. These same researches render it 
highly probable that a rich and fertile soil in which de- 
composable substances are retained near the surface 
by any cause, whether a clay subsoil, or a ledge of rock, 
or a protracted drought, is a soil favorable to the pro- 
duction of this disease. 

This suggests the importance of choosing a locality 
for a house where there is a sandy or gravelly subsoil, 
or if that cannot be had, to have the vicinity of the 
house thoroughly tile-drained, the cellar kept scrupu- 
lously clean, and its walls thoroughly cemented. The 
sleeping-rooms should be in the second or third floor, 
and no part of the house should rest directly upon 
the ground, without cellarage. The privy should be 
frequently cleaned, and, between times, be disinfected 
by the free use of dry earth, as we have before de- 
scribed, or by pouring down carbolic acid. When 
there is a water-closet in the house, it should be care- 
fully watched, lest sewer gas escape. 

THE PREVENTION OF SWAMP FEVERS. 

Chills and fever, fever and ague, or intermittent 
fever, as the same disease is variously termed, is ex- 
ceedingly common in the low and swampy parts of 
the Southern and Western States, and in the autumn 
occurs in similar localities all over our country. It is, 
like typhoid fever, apparently caused by some exhala- 
tion given out by decaying vegetable matter, and is 
most common where large quantities of such sub- 
stances are exposed to the sun. As this is especially 



TO PREVENT MALARIAL DISEASES. 251 

the case in swamps and marshy lands, the exhalation 
which causes the disease is called the "swamp poison," 
or "marsh miasm." 

It gives rise not only to the disease we have men- 
tioned, but to congestive chills, break-bone fever, 
remittent fever, and that complaint common in 
Louisiana, called the dengue. All sexes and ages are 
liable to it, and though strangers are more readily 
affected, no amount of acclimatization protects from 
its effects. The dangerous Campagna fever of Rome, 
the Palestine fever which annually carries off so many 
pilgrims to the Holy Land, the "mountain fever" of 
the Colorado miners, and most other fevers peculiar 
to localities, are probably of the same nature. The 
"shakes" are so universal in some parts of the Missis- 
sippi Valley, that they are looked for in the autumn 
almost with the same confidence as the corn-huskino: ! 
Their prevention, therefore, is a matter of the highest 
importance. 



TEMPORARY PRECAUTIONS. 

"We shall first mention the precautions which travel- 
lers and temporary visitors in unhealthy districts 
must observe, and next those which permanent resi- 
dents should attend to. 

A person who visits a region known to be malarious 
should assume at once the peculiar mode of life of its 
inhabitants, as regards food and drinks. The water 
drank should be boiled and cooled, or made into a tea, 
or prepared in some similar manner. The clothing 



252 THE PREVENTION OF SPECIAL DISEASES. 

should be carefully suited to the temperature of the 
time of day, every precaution taken not to become 
chilled, and the evening and night air as much as 
possible avoided. The windows should be closed at 
night, and an open fire be lighted in the evening. It is 
a well-established fact that fire destroys the swamp 
poison, and when, as in camping out, persons lie all 
night in the open air, a large fire, well kept up, is 
a most efficient means of protection. A dwelling 
should be sought on as high and as dry a situation 
as practicable. The sleeping-room should be in the 
upper story of the house. Caution should be exer- 
cised not to get wet or damp from dew or rain, and 
all excesses should be scrupulously shunned. The use 
of vegetables and milk should be limited, and bathing 
in ponds or rivers, especially after sundown, is dan- 
gerous. 

SPECIFIC PREVENTIVES. 

As specific preventives to fever and ague, there have 
been recommended tobacco and quinine. An ex- 
tended discussion of the merits of the former in the 
Medical and Surgical Reporter of Philadelphia, a year 
or two back, resulted in proving that the popular idea 
that the employment of this narcotic is an effectual 
preventive, is quite erroneous. "Whatever other vir- 
tues it may have, it has not this. 

The same cannot be said of quinine. This invalu- 
able preparation from Peruvian bark should be carried 
by all those who temporarily visit a fever and ague 
district. It may be put into the form of pills, three 



TO PREVENT CHILLS AND FEVER. 



253 



grains each, one of which, taken before breakfast, will 
prove an admirable safeguard ; or in the form of 
"bitters," which is a more popular though not so 
unobjectionable a method of administering it. The 
numerous bitters advertised for this purpose by patent 
medicine venders are not to be used, as they frequently 
contain no preparation of Peruvian bark at all; but 
a good, efficient, home-made bitter should be preferred, 
such, for example, as can be made from either of the 
following receipts, one containing alcohol and one 
without it: — 



Take of— 

Gentian root, one ounce. 
Wild-cherry bark, half an ounce. 
Peruvian bark, one ounce. 
Boiling water, one quart. 
Simmer fifteen minutes and strain. Dose, a wineglassful. 



Take of— 

Sherry wine, one quart. 

Peruvian bark, two ounces. 

Ginger, bruised, quarter ounce. 
Dose, a tablespoonful. 



PERMANENT PREVENTIVES. 

Some people are afraid to take quinine, and some 
may not have it convenient. "We recommend to such, 
as a very excellent, convenient, and cheap preventive, 
a strong tea of the calamus root, a wineglassful every 
morning before breakfast. 

Permanent Residents must, in addition to such of 
the above counsels as are applicable to them, observe 



254 PREVENTION OF SPECIAL DISEASES. 

some other rules. Their dwellings should be built on 
as high and dry grounds as possible, the cellar well 
aired and drained, the rooms fitted for large open fires, 
and the site chosen should be to the windward of any 
large marshes (with reference to the prevailing winds). 



ADVANTAGE OF TREES. 

Trees and thick bushes should be left, or if not 
present, be planted, between the house and the adjacent 
low grounds, as they very materially intercept the 
swamp poison, and have an attraction for it. 

Among the Romans, the advantage of such barriers 
has long been recognized. Trees were planted in rows 
and masses to guard against the diffusion of malaria. 
The practice was enforced by law, and recorded 
in the Roman tablets. This law, which was reported 
by Cicero— " Lucos in agris habinto" — evidently had 
reference much more to the advantage in question 
than for the purposes for which trees are usually 
planted. In order to insure their safety, such collec- 
tions of trees were placed under the protection of some 
divinity, or under the responsibility of the Roman 
consuls. 

Bapt. Donus, in his work "On the Means insuring 
Salubrity to the Soil of the Roman States," recommends 
the planting of pine and other trees between Rome 
and the Pontine Marshes, to intercept the miasmata 
wafted from there by the southwest winds. At 
Velletri, as also at Campo-Salino, the destruction of 
belts of woods was followed by the prevalence of fever. 



TO PREVENT CHILLS AND FEVER. 255 

Dr. Lewis, in his "Medical History of Alabama," 
says : ""Mr. P. E. had negro-quarters situated on the first 
prairie elevation above the low lands of a small creek, 
the fourth of a mile from the houses. The belt of low 
ground frequently overflowed, causing water to remain 
in holes over its entire breadth, in the subsidence of 
the stream ; but it was well shaded by a dense foliage, 
the plantation lying on the prairie in the rear of the 
cabins. In the winter of 1842 and 1843 the trees 
between the houses and creek were cleared away, and 
up to that time, some eight or ten years, the negroes 
living in this quarter had enjoyed uninterrupted 
health — a case of fever scarcely occurring. During 
the summer of 1843, the first after the forest had been 
cleared away, fever prevailed among the negroes with 
great violence, continuing until frost. The negro- 
quarters were afterwards removed to the opposite side 
of the creek, about the same distance from it, but with 
an intervening growth of timber, and no fever has 
occurred on the place since." 

Indian-corn should not be planted close around or 
very near the house (say within two hundred yards), 
as it is unquestionably a promoter of the miasm. 

ADVANTAGE OF PLANTS. 

On the contrary, the common sunflower (Helianthus 
annuus) has been spoken of, on good authority, as a 
corrective of the miasmatic poison of low lands. A 
recent medical journal relates that a swampy tract on 
the river Schede, in Belgium, was so unhealthy from 



256 PREVENTION - OF SPECIAL DISEASES. 

this cause that the government proposed to take official 
steps to remedj/ it. One of the land-owners in the 
district, who had suffered from chills annually for three 
years, commenced raising sunflowers. He planted 
three or four groups of them forty or fifty yards from 
his house in various directions. They flourished 
astonishingly, raising large, heavy flowers. Ever since 
then he and his family, including laborers and visitors, 
have been entirely free from the disease. A number 
of his neighbors have followed his example, and have 
enjoyed the same immunity; while those who have 
not raised the sunflowers, suffer as much as formerly. 
This fact, coming as it does from an authentic source, 
is well worthy of general dissemination. 

Lieutenant Maury believed that a few rows of sun- 
flowers, planted between the "Washington Observatory 
and the marshy banks of the Potomac, had saved the 
inmates of that establishment from the intermittent 
fever, to which they had been formerly liable. These 
experiments have been repeated in Italy. Large plan- 
tations of sunflowers have been made upon the alluvial 
deposits of the Oglio, above its entrance into the lake 
of Iseo, near Pisogne, and, it is said, with beneficial 
effects. 

Dr. Cartwright ascribes to the Jussicea grandiflora, 
a plant found in great abundance in marshy or swampy 
places in the Southern States, particularly in certain 
regions of Louisiana, which present the usual charac- 
teristic malarial surfaces, the cause of their exemption 
from fever. Aquatic plants, and those found in 
swampy or marshy soils, while growing, exhale a large 



TO PREVENT CHILLS AXD FEVER. 257 

quantity of oxygen; but when they have their growth, 
this action ceases, and those regions become unhealthy. 



USE Or PETROLEUM. 

Another substance, which acts as a preventive, is 
petroleum. It has been observed, especially in the 
East Indies, that, in extremely unhealthy districts, 
where the fatality from congestive chills is notorious, 
and where labor in the open air is dangerous even to 
the natives, the government laborers, employed in the 
petroleum works are absolutely exempt from any 
signs of the disease. The probable reason of this is 
that petroleum contains carbolic acid, the best and 
most potent of all disinfectants. The fact may be 
utilized by those exposed to the complaint. They 
should keep petroleum or the acid in their houses, 
disinfect their sinks, etc., with it, and place saucers of 
it in the rooms. 

USE OF CIDER. 

Finally, we may add the statement of a New Eng- 
land physician, Dr. "Warner, who has spent many years 
in localities exposed to fever and ague. He asserts 
that he has observed that persons accustomed to drink 
cider freely, are not so liable as others to diseases pro- 
duced by swamp-poison. We may suppose this owing 
to the "malic acid" present in the juice of the apple, 
which acts as a preventive. 

17 



258 THE PRETENTION OF SPECIAL DISEASES. 
TO PREVENT CHOLERA. 

Fortunately, for some years past, we have been 
spared those terrible visitations of this dreadful dis- 
ease which, at several periods within the memory of 
many, have well-nigh desolated our cities. But we 
cannot rely upon this immunity in the future, and it 
is well, therefore, for all to be acquainted with the rules 
for personal government in the event of such another 
epidemic. We give those united upon by various 
distinguished physicians of experience in this malady, 
and which have proven efficacious in repeated in- 
stances. 

PERSONAL PRECAUTIONS. 

Since the disease is communicable, and there is con- 
sequently more danger in a house and in a city where 
it exists, those who can journey elsewhere should do 
so. They should start early, go entirely out of the 
reach of the disease, and stay away until it has com- 
pletely disappeared. Those localities are most free 
from the disease which have a cool, dry atmosphere ; 
hence the mountains rather than the seashore should 
be preferred. 

Those whose duty or necessity obliges them to re- 
main, should, beyond all else, refrain from using a 
strange or a common water-closet. The poison of 
cholera is conveyed chiefly by the passages of patients, 
and soon infects a whole privy. Portable earth-closets 
should be used, and the utmost attention to their clean- 



TO PREVENT CHOLERA. 259 

liness be given. The common closets should he fre- 
quently disinfected by pouring down them carbolic 
acid. 

The diet should be of articles easy of digestion, and 
whatever tends to diarrhoea must be avoided. Com- 
plete and sudden change in the mode of life is not 
desirable. If any spirituous liquor whatever is taken, 
it should be only small quantities of good red wine 
with the meals. All excesses, either in food or drink, 
should be shunned. The recommendation sometimes 
made, to use brandy or other alcoholic beverage as a 
preventive, is pernicious and dangerous counsel ; all 
such drinks have an injurious, and not a protective 
power, and should be wholly shunned. 

There need not be an entire abstinence from fruit 
and vegetables ; but the indulgence in these articles 
should be limited, and confined to such as are ripe 
and fresh. Very serious mischief results from eating 
fruits unripe or partially decayed, and wilted or stale 
vegetables ; but not from the consumption of those 
which are in good condition. Fruit should be taken 
in the morning, and never in the evening. So familiar 
is this precept to residents of tropical climates, that 
the Spaniards have a proverb that the orange is "gold 
in the morning, silver at noon, but lead at night." 

Cucumbers, sourkrout, pickles, cabbage, and in 
general all foods which from experience have been 
found to disturb the bowels, should be taken with the 
greatest caution, or altogether shunned. Meat should 
be well done, and from healthy animals. 

It is important that the mind be free from anxiety 



260 PREVENTION OF SPECIAL DISEASES. 

and fear. A marked dread of the disease, and con- 
stant timidity about contracting it, predispose the 
system to its attack, and leave a diminished power 
of resistance. 

Severe exertion, prolonged vigils, and fatigue 
should be avoided, inasmuch as they lower the ability 
of the system to throw off the poison which floats in 
the atmosphere. Exposure to a hot sun or to chilly 
night air has a similar effect. 

Personal cleanliness is essential. A bath should be 
taken daily, and all the clothing changed weekly. A 
flannel undershirt should be worn, sufficiently long to 
cover and protect the bowels. 

PREVENTIVE TREATMENT. 

The observation of many thousand cases of cholera 
proves that in the vast majority of instances it is 
preceded by a looseness of the bowels, with little or 
no griping, the discharges not very numerous, and 
increasing in fluidity, the duration varying from one 
to ten days. This painless diarrhoea, known as the 
cholerine, is usually not heeded, and the fully de- 
veloped disease is allowed to invade the system ere 
any remedial steps are taken. This is too often a 
fatal mistake. The proposition has been laid down 
by an eminent French authority (Jules Guerin): — 

"That it is always possible to arrest the develop- 
ment of the fatal stage of cholera by attacking the 
disease in its curable one." 

This curable stage is that of the cholerine. It 



TO PREVENT CHOLERA. 261 

should always be attended to without delay. The 
remedies are not brandy and opium, too frequently 
offered, and which only serve to give a delusive and 
temporary relief, under cover of which the main 
disease steadily advances; but perfect rest in bed, 
a careful and limited diet, and the administration of 
laxatives, in order that nature may be aided in dis- 
charging from the system the poisonous material 
which has obtained lodgement there. The best of all 
laxatives for this purpose is castor oil, a tablespoonful 
of which should be taken morning and evening until 
the character of the discharge is changed. 

After this has been effected, which should be in 
thirty-six hours if not less, much benefit will be 
derived by using a dilute mineral acid. This may be 
taken by mingling a teaspoonful of aromatic sulphuric 
acid in a pint of water, of which a small tumblerful 
should be taken every hour or two. If there is vomit- 
ing, it should be taken immediately after the act. 
Cool water may be taken freely. 

The passages from the bowels should be received 
into a vessel containing a solution of carbolic acid, 
and at once removed from the room. The patient 
should not go to the water-closet. 

Some hot coffee or some peppermint tea may be 
taken, but the external application of heat does no 
good, and may do harm. 

SPECIFIC PREVENTIVES. 

As specific preventives, many preparations have 
been lauded. In Russia, persons took a raw egg and 



262 PREVENTION OF SPECIAL DISEASES. 

a half teaspoonful of powdered charcoal every morning, 
with alleged success. There are also some " Russian 
cholera drops" much celebrated. They would doubt- 
less render good service in some instances where there 
is disturbance of the bowels present, and we give the 
recipe : — 



Take of— 

Ethereal tincture of valerian, two drachms. 

Wine of ipecac, one drachm. 

Laudanum, twenty drops. 

Oil of peppermint, five drops. 
Give 25 drops every hour or two. 



A " cholera pill" which has been distributed by tens 
of thousands in the towns and villages of India, where 
cholera is almost constantly present, and which has 
given very satisfactory results, is composed as fol- 
lows : — 



Take of— 

Powdered opium, ten grains. 

Black pepper, twenty grains. 

Assafcetida, thirty grains. 
Make into ten pills. 



After indigestible food or other matter in the bowels 
has been removed by an emetic or a dose of castor oil, 
one of these pills should be taken. If the looseness 
continues, another should be swallowed after the lapse 
of three or four hours. 

"We must here warn our readers against a blind reli- 
ance in the advertised " cholera medicines." They are 
generally useless, and often dangerous ; and when they 
do give relief, the result too often proves that it is but 



TO PREVENT CHOLERA. 263 

a transient and fallacious ease, under which the real 
malady is gathering strength and insuring a victory. 

Cholera is essentially a preventable disease. But, to 
prevent it completely, families, cities, and the common- 
wealth must unite in their efforts. "What the duties 
of public bodies are, it is unnecessary to explain. But 
we will add, what every household should look to, 

GENERAL PREVENTIVE MEASURES. 

It should be generally known that the dangers 
which have to be guarded against as favoring the 
spread of cholera contagion are particularly two. 
First, and above all, there is the danger of water sup- 
plies which are in even the slightest degree tainted by 
house refuse or other like kinds of filth ; as where 
there is outflow, leakage, or filtration, from sewers, 
house-drains, privies, cesspools, foul ditches, or the like, 
into streams, springs, wells, or reservoirs, from which 
the supply of water is drawn, or into the soil in which 
the wells are situated: a danger which may exist on a 
small scale at the pump or well of a private house; or 
on a large scale, in the source of supply of public 
water works. And, secondly, there is the danger of 
breathing air which is foul with effluvia from the same 
sorts of impurity. Information as to the high degree 
in which these two dangers affect the public health in 
ordinary times, and as to the special importance which 
attaches to them at times when any diarrhceal infection 
is likely to be introduced, has now for so many years 
been before the public, that the improved systems of 



264: PREVENTION OF SPECIAL DISEASES. 

refuse removal and water supply, by which the dan- 
gers are permanently obviated for large populations, 
ought long ago to have come into universal use. 

So far, however, as this wiser course has not been 
adopted, temporary security must, as far as practicable, 
be sought in measures of a palliative kind. 1st. Im- 
mediate and searching examination of sources of water 
supply should be made in all cases where the source is 
in any degree open to the suspicion of impurity; and 
the water both from private and public sources should 
be examined. Where pollution is discovered, every- 
thing practicable should be done to prevent the pollu- 
tion from continuing, or, if this object cannot be 
attained, to prevent the water from being drunk. 2d. 
Simultaneously, there should be immediate thorough 
removal of every sort of house refuse and other filth 
which has accumulated in neglected places; future 
accumulations of the same sort should be prevented; 
attention should be given to all defects of house drains 
and sinks through which offensive smells are let into 
houses; thorough washing and whitewashing of un- 
cleanly premises, especially of such as are densely 
occupied, should be practised again and again. 3d. 
Disinfection should be very freely and very frequently 
employed in and round about houses, wherever there 
are receptacles or conduits of filth, wherever there is 
filth-sodden porous earth, wherever anything else, in 
or under or about the house, tends to make the atmos- 
phere foul. In the absence of permanent safeguards, 
no approach to security can be got without incessant 
cleansings and disinfections, or without extreme and 



TO AVOID A TERRIBLE DISEASE. 265 

constant vigilance against every possible contamina- 
tion of drinking water. 



TO PREVENT HYDROPHOBIA. 

This is one of the most terrible diseases which the 
physician ever witnesses. The agony is horrible to 
contemplate, and the result hopelessly fatal. But it 
can he prevented, and every person should understand 
how to do this, and be ready to apply the means. 

We must first say a few words of the nature of the 
disease. Usually it is contracted from a mad dog, 
but cats and other animals occasionally communicate 
it. The poison which propagates hydrophobia exists 
in the saliva of the rabid animal, and merely "besmears 
the tooth. It produces no irritation and no immediate 
effect, but, like the virus of the smallpox, remains a 
certain period in the blood before the system becomes 
affected. The period in the production' of canine 
madness varies, but it is commonly about six weeks, 
and then, before constitutional disease is developed, a 
slight irritation occurs in the scar, and the wounded 
member becomes violently inflamed. 

When these phenomena take place there is no hope, 
and the constitutional symptoms follow immediately. 
However, if, during the long period which precedes 
the symptoms mentioned above, the proper remedies 
be employed, and especially soon after the bite the 
prevention of the disease is almost certain. 

A deep wound inflicted by the bite, it is asserted, is 
less likely to be followed by hydrophobia than is a 



266 PRETENTION OE SPECIAL DISEASES. 

slight scratch abrading the skin, since the copious 
effusion of blood washes away the poison. 



PREVENTIVE TREATMENT. 

The preventive treatment is as follows: Let the 
wound be instantly washed again and again with soap 
and water, and then apply a cylindrical piece of 
caustic potash cut in the shape of a pencil point, and 
hold it firmly in the bite for fifteen seconds, without 
regard to the pain, which will be severe. Caustic 
potash, in cylindrical pieces, can be obtained of any 
druggist; but if the accident should happen in the 
country, remote from the shops, it can be made extem- 
pore by pouring boiling water on wood-ashes, straining 
out the lye, and boiling it down to the consistency of 
molasses. This substitute may be applied with a 
smooth stick. 

"When the wound is a mere scratch, and therefore 
more dangerous, wipe it over briskly with the caustic 
potash. Nitric or sulphuric acid, diluted, may also be 
used ; but milder caustics, which do not destroy the 
surface of the wound, cannot be relied on, although 
Mr. Youatt recommends nitrate of silver. After the 
application of the caustic, the wound may be poulticed 
with bread and milk for two days, and then dressed 
with simple salve. 

Professor Smith, of Baltimore, says that in the 
course of fifty years' practice, he has had occasion, in 
many instances, to treat the bites of dogs undoubtedly 
rabid, and has never known the disease to result, when 



TO AVOID THE CAUSES OE APOPLEXY. 267 

the above preventive measures were employed within 
three days after the bite 

V. Diseases not Contagious. 

THE PREVENTION OF APOPLEXY AND PALSY. 

These diseases are largely confined to those who are 
well advanced in years. They are so lamentable and 
so irresistible in their effects, that it is the more 
imperative for every one to avoid the causes which pre- 
dispose to them. Paralysis, or palsy, is usually conse- 
quent upon a stroke of apoplexy, so we can properly 
treat of them together. 

There is a prevalent opinion that those who are 
"full-blooded," with a red face, a short thick neck, and 
a robust habit, are alone liable to apoplexy. This is 
by no means the case. The thin and pale are quite as 
much in danger of it. There are in fact two varieties 
of the disease, one depending upon a plethoric condi- 
tion of the system, and the other upon a deficiency of 
good blood. 

One of the earlier premonitory warnings of a 
tendency to this complaint is a "swimming in the 
head," as it is familiarly termed, in other words, 

DIZZINESS OR VERTIOO. 

When this is accompanied by a feeling of heat and 
fulness in the head, a flushed face, an injected eye, and 
noises in the ears, it indicates that there is too much 
blood in the brain, and the sufferer should at once 



268 PREVENTION OF SPECIAL DISEASES. 

reduce his diet, keep his bowels open with saline 
mineral waters, and avoid getting overheated. These 
attacks usually are produced by exertion, or by tight 
collars or cravats, or some other cause which drives 
the blood to the head. 

Another kind of vertigo is characterized by paleness 
of the face, a sense of faintness, and sometimes sick- 
ness of the stomach; it is sudden and transient, though 
sometimes leaving after it a headache. This is from a 
lack of blood in the brain, and requires very different 
treatment from the other form of attacks. It may also 
portend an apoplectic stroke, and demands even greater 
care to prevent bad consequences. It is by no means 
of trivial moment. It demands entire rest and relaxa- 
tion, a nourishing diet, gentle regular exercise, and a 
judicious course of tonic medicines. 

Unless these warnings are heeded in time, it may 
proceed to an actual stroke, the result of which is 
frequently to incapacitate the sufferer ever after from 
active participation in the affairs of life. 

"We do not wish it to be understood, however, that 
occasional attacks of dizziness are always so porten- 
tous as these. Such attacks may be derived from a 
variety of causes, as, for instance, from heart disease, 
dyspepsia, loss of blood, and nervous disorders. 

After a first attack of apoplexy there remains a 
strong predisposition to a second and a third, one of 
which usually proves fatal. The most that can be 
done is sedulously to guard against the causes which 
have brought about the first seizure, and improve the 
general health by any available means. 



INJURIOUS AMERICAN HABITS. 269 

TO PREVENT INDIGESTION AND DYSPEPSIA. 

These extremely frequent complaints arise from 
such a variety of causes, that we cannot wonder at 
their extent. Some of the most common are eating 
too much, eating too little, eating indigestible articles, 
eating at irregular hours, and eating too rapidly. 
"We have given directions on these points on an 
earlier page, which will be sufficient to guard our 
readers. 

The crime of gluttony is one happily much less 
prevalent in this age than in former ones, and in 
this country than in the higher circles of European 
States. The arts of the kitchen are with us in their 
infancy, and the temptation is rare to partake of food 
in excess. On the other hand, it is almost a national 
failure to hasten our meals and half masticate our 
food. These, together with the abuse of alcohol and 
tobacco, are the prevailing causes of dyspepsia among 
men in middle life. 

The consumption of distilled spirits, at all times 
objectionable, is particularly harmful in the manner in 
which it is carried on in this country, which is not at 
meals, as in Europe, but on an empty stomach, often 
in the forenoon. An eminent London physician says 
on this point: "The test I apply to discover whether 
the amount of alcohol taken is such as to injure the 
stomach is to inquire whether the patient is accus- 
tomed to take a dram in the forenoon. If so, I at 
once feel sure that the stomach has suffered. I have 
not yet met with a forenoon tippler, even though he 



270 THE PREVENTION OE SPECIAL DISEASES. 

never got drank in his life, without a condition of 
stomach which must infallibly shorten his days." 

The use of articles very hot or cold, such as hot tea 
and coffee, and ice-water in quantities, is sure sooner 
or later to tell unfavorably upon the digestive organs. 
It is wiser to take all substances at as near the tem- 
perature of the stomach or body itself as may be. 

Confirmed sedentary habits lead to indigestion 
more by the confinement in an impure atmosphere, 
and by withdrawing the nervous force from the 
stomach, than in any other manner. When these 
concomitants are withdrawn, as, for instance, in some 
bedridden persons, and in the inmates of well-venti- 
lated cells, indigestion is rare. Indeed, there is every 
reason to believe that, with proper care, persons forced 
to pursue the most sedentary avocations can remain 
in perfect health to an advanced age. 

Inaction of the body is in fact less likely to impair 
the nutrition of the body than inaction of the mind. 
People who have nothing to do always magnify their 
own ailments, and give themselves so much worriment 
about their health that they often end in undermining 
it entirely. Many men first suffer from dyspepsia 
when, after a number of years spent in accumulating 
money, they give up business in order to enjoy life.(!) 
In nine cases out of ten the result is anything but 
what they anticipated. In the interest of their 
stomachs, if not of their fellows, we advise them to 
continue their occupations. 

Excessively hard labor shou.d also be avoided, as, 
when this is performed, especially soon after or before 



TO AVOID DYSPEPSIA. 271 

a meal, it very soon weakens the stomach. Continued 
nursing in women has the same effect. 

Even more deleterious are worry and anxiety about 
business and domestic affairs. An eminent physician 
and professor in this country used to state in his lec- 
tures that he was obliged in early life to give up the 
practice of midwifery, for as soon as he was summoned 
to a case of labor, such was his anxiety about it that 
he was invariably seized with a violent spell of indi- 
gestion. 

Disappointment and ill-success are common causes 
of dyspepsia, avoidable in one sense, not in another. 
"We may not be able to prevent them, but we can at 
any rate bear them with more fortitude than is often 
shown. They are very certain to debilitate the system, 
and always commence by deranging the digestion. 
There is no tonic equal to success. The prosperous law- 
yer or merchant will accomplish without the slightest 
injury more hard work than would serve to break him 
down body and mind if he was steadily and hopelessly 
losing money instead of making it. It makes all the 
difference in the ease with which we swim, whether 
the current is for us or against us. It is worry, not 
work, that kills. 

Those occupations which are either directly poison- 
ous, or which interfere with the taste for food by viti- 
ating the air, soon lead to dyspepsia, as also -do those 
which force the body into a cramped and uncomfort- 
able posture. Shoemakers' and tailors nearly always 
have digestive trouble of some sort. Needle-women, 
who bend over their work all day, and laborers in fac- 



272 THE PREVENTION OF SPECIAL DISEASES. 

tories where the air is tainted with bad smells, or 
where the temperature is constantly high, are also 
frequent victims. 

The vast quantities of patent medicines which every 
year are swallowed by the public are to blame for a 
very large percentage of the cases of dyspepsia. The 
syrups, and bitters, and extracts, vaunted for their 
nameless cures in the advertising columns of the papers, 
really cause more illness than they cure. The nume- 
rous pills sold under high-sounding names are always 
without exception purgative, and the frequent use of 
purgative medicine is one of the very surest roads to 
a decided case of dyspepsia. The temporary relief 
which these medicines give is illusory and in the end 
they only plunge the patient more irretrievably into a 
confirmed state of invalidism. 



TO PREVENT DIARRHOEA AND DYSENTERY. 

These and other bowel complaints are more frequent 
in the hot months than in winter. Hence we are 
often called upon to believe that their increased fre- 
quency during the warm season is owing to the vege- 
tables and fruits consumed at that time. It is quite 
likely that eating unripe or wilted fruit and vegetables 
causes disturbances of the stomach and sickness; but 
it is of a temporary character, and will generally cure 
itself if no other cause is present. 

A total abstinence from fruit and vegetables at 
such periods would certainly produce far more sick- 
ness than even intemperate indulgence in them. In 



TO AVOID DIARRHCEA AND DYSENTERY. 273 

hot climates and during the hot months the taste 
naturally prefers an almost exclusively vegetable diet, 
and one in which fruit holds a conspicuous part. 
"When ripe and fresh, nothing is more wholesome, and 
the gifts of nature at this season may be indulged in 
freely, though of course not gluttonously. 

A far more frequent cause of diarrhoea and dysentery 
is a chill. In the hot nights of July and August 
nothing is more delightful than to divest one's self of 
clothing at night, and feel the cool and soft air play 
around the body — and nothing is more dangerous ; for 
a chill may creep upon one insensibly, and lay the 
foundation of a severe and perhaps fatal illness. 
Therefore, even in the hottest nights, one should sleep 
under a sheet or some covering. 

A comparatively slight change of temperature af- 
fects the system when it is prostrated by a long heated 
term. As at such times the stomach and bowels are 
the parts most likely to be attacked, it is prudent to 
have them always protected by a thin flannel under- 
shirt, or else by an eight inch broad band of flannel 
passed around the body. This is a very efficient pro- 
tection, and should not be neglected by those who 
have a tendency to weakness of the bowels. 

During the war, when dysentery was very prevalent 
in some of the regiments, many of the men adopted 
with benefit the use of the "spice belt." This is a 
broad flannel belt of double thickness, containing; in 
the fold coarsely ground ginger, cloves, allspice, and 
red pepper. The surgeons attributed the protection 
this gave quite as much to the flannel as to the spices, 

18 



274 THE PREVENTION OF SPECIAL DISEASES. 

but doubtless they too had some effect, and the device 
grew into deserved esteem. 

Bathing the chest and belly every morning with 
cold water, or with vinegar and water, equal parts, 
exerts a salutary effect by lessening the sensitiveness 
of the body to the impression of cold. 

Impure water is a frequent cause of obstinate 
diarrhoeas. When it is possible to filter it before 
drinking, it should be done; if conveniences for this 
are not at hand, then it should be boiled or heated and 
allowed to cool before use; and if this too is practically 
impossible, it is better to mingle with it a few drops 
of tincture of ginger, as this diminishes its tendency 
to sickness and nausea. 

It is hardly necessary to speak of the necessity of 
avoiding irritating and indigestible food of all kinds, 
and refraining from immoderate use of ice-water and 
other beverages in warm weather; as on previous 
pages we have spoken at length of the rules which 
should govern us in reference to these things. 

TO PREVENT WORMS. 

The most familiar worms which infest the human 
species are the tapeworm, the round worm, and seat 
worms. These and all other kinds are most probably 
derived from some external source, and do not per- 
petuate their species in the body. We know this of 
the tapeworm. This ugly parasite, often fifteen and 
twenty feet long, is nearly always derived from eating 
pork which is insufficiently cooked. The Jews and 



TO PREVENT WORMS. 275 

Mahommedans, who do not eat the flesh of this animal, 
are very rarely subject to it. On the contrary, when, 
as during our late war, it constitutes a very frequent 
article of diet, often raw or half cooked, tapeworms are 
numerous. 

The flesh of sheep and beef may also, but more rarely, 
convey the eggs of worms into the stomach. It 
should, therefore, be always pretty thoroughly cooked. 
Vegetables which are eaten raw, such as salad, lettuce, 
radishes, and fruit, should always be carefully washed 
or wiped, as they, too, sometimes have on their outer 
surface deposits of eggs. 

Cooks and butchers are liable to worms more than 
others, and should, therefore, be very cautious. They 
should not hold a knife in the mouth which is used in 
cutting raw meat, nor should they use it to cut bread, 
etc. Their hands should always be well washed be- 
fore being used for other work, and scraps of meat 
should be gathered up and put aside. 

It has been proven by a number of instances that 
pet dogs, as lapdogs, etc., which are much caressed, 
convey occasionally parasitic worms to their masters 
and mistresses. The dog is peculiarly subject to cer- 
tain varieties of these parasites, and they readily pass 
from them into the human species. 



THE PREVENTION OF SKIN DISEASES. 

Skin diseases are of numerous varieties, very com- 
mon, and often sadly disfiguring. In the interests of 
good looks as well as good health, they should be pre- 



276 THE PREVENTION OF SPECIAL DISEASES. 

vented, and we can lay down some very practical 
rules in this respect. Whatever is generally beneficial 
to the health is also preventive of these diseases ; and 
besides such general directions there are a number of 
special precautions which should be observed. "When- 
ever a person has actually suffered from them, or has a 
hereditary tendency to them, he will do well to adopt 
rigidly these measures. 



CLEANLINESS 

Must be enforced with more than ordinary care. Not 
only should the skin be washed frequently, but it 
should be rubbed thoroughly though not harshly with 
a towel, and, if inclined to be dry, harsh, and cracked, 
should be anointed with a small quantity of glycerine 
or fresh olive oil, well rubbed in. The parts most ex- 
posed, the face, hands, and neck, may be dusted with a 
little rice or starch powder, and should be protected, the 
hands by gloves, the face by veils or a broad-brimmed 
hat, when the weather is very hot or very cold. One 
should not go out-doors immediately after washing the 
face, unless a little oil or glycerine is rubbed in, as the 
skin is otherwise inclined to chap. 

In bathing, the water should neither be hot nor cold, 
but only tepid. Any extreme temperature predisposes 
the skin to eruptions, and leads to a disturbance of the 
functions. Many persons who have adopted the very 
good habit of a cold bath every morning are much 
annoyed in winter by an itching of the body, especially 
at night. They will find themselves benefited by a 



TO PREVENT SKES" DISEASES. 277 

moderation of the temperature of their bath, and by 
throwing into it a tablespoonful of glycerine, or by 
sponging the surface occasionally with a strong solu- 
tion of iodide of potassium. 



THE DIET 

Requires to be carefully regulated in those liable to 
skin diseases. It is repeatedly observed that schools 
and other institutions where the food, though nour- 
ishing, is monotonous, are very exposed to epidemics 
of skin diseases, which will promptly disappear on 
changing the bill of fare. "Whenever there is indi- 
gestion, constipation, or any long-continued indispo- 
sition of this nature, the system is more open than 
otherwise to the outbreak of a skin disease, and often 
the promptest method of curing it when present is 
to remedy the disorder of the bowels. 

Indeed, there are certain articles of food which in 
some persons invariably give rise to severe and 
painful eruptions. Lobsters, oysters, and other shell- 
fish never agree with some persons, always causing a 
breaking out of temporary character. So, again, many 
persons cannot indulge in beer, wine, or spirits with- 
out paying a similar penalty for their pleasure ; and a 
lesser number always suffer if they partake too freely 
of animal food. These are peculiarities of tempera- 
ment, which, when once learned by experience, should 
be respected thereafter. 

On the contrary, too low a diet, very often adopted 
with a view of "cooling the blood," is generally a 



278 THE PREVENTION OF SPECIAL DISEASES. 

mistake, and aggravates the evil which it is at- 
tempted to remove, as a tendency to eruptions more 
frequently depends upon debility than on a plethoric 
condition of the system. 

Many persons are greatly annoyed with a violent 
itching, without any eruption, coming on every winter 
and passing off towards spring. In many cases the 
secret of this is the use of buckwheat cakes at this 
season of the year, that grain producing in many 
constitutions a very troublesome and obstinate irrita- 
tion. 

CLOTHING, 

Especially that next the skin, has much to do with 
the causation and prevention of skin disease. Some 
skins are so irritable that they become excited to an 
unbearable degree by the use of flannel. These 
should place a garment of thin linen between the 
flannel and the skin. A remembrance of this little 
point will often give such persons the greatest cause 
to be thankful for the suggestion. 

Others, again, find a similar irritation from the use 
of silk, caused chiefly from its electrical action. They 
should employ a similar precaution. 

The color of undergarments is not a matter of no 
importance. On the contrary, persons occasionally 
owe very troublesome skin diseases to a want of pru- 
dence in this regard. Corolline and similar dyes 
belonging to the aniline colors, and some greens, exert 
a poisonous action on the skins of most, and when 
stockings and gloves are dyed with them, the parts in 



TO PREVENT SKIN DISEASES. 279 

contact suffer from obstinate eruptions. As a rule, 
only undyed goods should be chosen for underwear. 



OCCUPATIONS. 

Some occupations are well known to be liable to cer- 
tain diseases of the skin. Cooks and firemen, whose 
faces are exposed to sudden alternations of strong heat 
and cool air, nearly always have eruptions on their 
skins ; bricklayers and masons have an eruption on the 
hands brought about from handling lime and mortar ; 
grocers are subject to the "grocer's itch," supposed to 
be contracted from dealing out raw sugar, which, as 
we have already mentioned, contains a small insect ; 
washerwomen have a troublesome cracking of the 
skin of the fingers, brought on by the constant expo- 
sure to the lye and strong soaps. Of course, the only 
method of avoiding such diseases is to avoid the 
causes which produce them. 

TO PREVENT SEA-SICKNESS. 

Many a delightful water-excursion is spoiled by the 
sea-sickness of some of the party. A vast number of 
means have been suggested for its prevention, most of 
them worthless. We will give what we believe to be 
the best. 

A person liable to it should go on board some hours 
after a full meal ; he should wear a silk handkerchief 
or scarf fastened tightly around his body, compressing 
his stomach ; he should keep on deck in the open air, 



280 THE PRETENTION OE SPECIAL DISEASES. 

and moving about; and he should avoid looking over 
the side of the vessel at the waves, or up at the spars 
or riggings, or going to the stern or bow of the vessel 
(where the motion is greatest). He should avoid 
thinking of the possibility of getting sick, or watching 
his own symptoms. Sitting on deck near the side of 
the ship, so that no swinging object interferes with a 
steady view of the horizon, often produces great relief 
from the earlier symptoms. 

The application of an ice-bag to the spine will pre- 
vent the unpleasant symptoms in some persons; while 
a warm stimulating drink, as a little hot tea or coffee, 
or ginger tea, will act equally well on others. Spiced 
food and aromatics, as "deviled biscuits" and cloves, 
relieve others. But too often no precautions will avail 
to escape it. 

Dr. O. Eapin, of Switzerland, says that he has found 
that the nausea and vomiting produced by swinging 
and sea-sickness can be arrested by applying to the 
pit of the stomach a layer of wadding dipped in collo- 
dion. It should extend from the breast-bone to the 
navel, and be left until it falls off. If the adhesion 
should be imperfect, the application should be renewed. 
Several persons, he says, have tried this plan with 
benefit. 

TO PREVENT DISEASES OF THE EYES. 

The faculty of sight is so all-important to the use- 
fulness of the individual, and its organ is so marvel- 
lously delicate, that every precaution should be observed 



TO PREVENT DISEASES OF THE EYES. 281 

to preserve them from premature decay and injury. 
The rules we give to that effect are drawn from the 
works of those eminent in that department, who have 
studied not merely the diseases of the eye, but how 
those diseases may be avoided. 

RULES FOR PRESERVING THE SIGHT. 

On awakening in the morning, do not expose the eyes 
to a sudden and violent light, but keep them half-shut 
for several minutes. 

Do not rub the eyes with the hand in awakening, 
should they feel irritable, as is often the case. Make 
use of a wet towel, with which they should be gently 
wiped. 

Bathe the eyes gently every morning and evening 
in pure water. 

In the ordinary apartment in which you work, have 
a steady, clear, but not dazzling light. Avoid a room 
which has windows down to the floor. The light 
should come from above and behind you. It should 
fall upon your work at an angle of about forty-five 
degrees, not from in front, but obliquely over the 
shoulder. 

Do not hold your work or a book behind the light, 
nor turn your back to the window so as to read with 
more facility. Such a position is very fatiguing to the 
organ. 

Avoid a position which exposes your eyes to the 
light reflected from a white wall or any polished surface. 

Shun as much as possible walking against high 



282 THE PREVENTION OF SPECIAL DISEASES. 

winds, or exposure on dusty roads or in rooms filled 
with floating particles. 

Never read lying down, nor in a railroad car, a 
street car, or a carriage. 

Spare your eyes by using a shade, and a violet or 
light blue chimney to your lamp or burner. 

If you are obliged to work before a bright fire, bathe 
the eyes frequently in cold water. 

Do not attempt to read at dusk nor by an insufficient 
light in the evening. 

"When you perceive the eyes are overtaxed, give 
them rest at once. Sometimes a single instance of 
neglect leaves behind it a long and even a permanent 
debility. 

Never attempt too much, either by using the eyes 
for a long-continued period, or by endeavoring to 
watch very small or distant objects. 

BENEFIT OF A SEA-VOYAGE. 

When the mischief is done, and when by age or 
overwork the eyesight is impaired and weakened while 
yet no actual disease is present, one of the most effica- 
cious means to restore its powers is a long sea-voyage. 
This is well known to naval surgeons. Dr. Roderick 
MacLaren, in a recent Scotch medical journal, tells of 
an old gentleman above sixty years of age who made 
the voyage to Australia in a sailing vessel. When 
three months out, while reading an old newspaper, he 
was astonished on putting his hand to his face to rub 
his eyes, to find that he had no spectacles on, as for 



TO PREVENT DISEASES OF THE EYES. 283 

many years before he left home he could not read 
newspaper type without them. The improvement was 
permanent. 

DANGER OF TIGHT BOOTS. 

A singular cause of weak eyes, but an unques- 
tionable one, is tight hoots. The editor of a leading 
British medical journal made the following remarks in 
a late number of his periodical : — 

"There is something after all in the notion and 
belief of our old lady friends that tight boots produce 
weak eyes. Since the new-fashioned boot made for 
and worn by ladies has come into use, we have been 
consulted in various instances, for a weakness of vision, 
and a stiffness about the ocular apparatus, which we 
found at first difficulty in accounting for, since we 
were unable to detect any abnormal condition of the 
eye to cause this disordered vision, or to trace any 
constitutional disturbance likely to provoke functional 
phenomena. A mother, wise in her generation, given 
to bestowing roses to Harpocrates, the god of silence, 
asked us if the tight boots worn by Tier daughter 
might not produce the distressing symptoms of 
asthenopia complained of. To this we assented, and, 
upon the tight boots being dispensed with, discovered 
that the cause of the mischief must have been removed, 
for the injurious effect upon the eyes ceased." 



284 THE PREVENTION OF SPECIAL DISEASES. 
DANGERS FROM USE OF ALCOHOL AND TOBACCO. 

"Weakness of the sight, and that affection called 
"color blindness," hi which colors cannot be distin- 
guished apart, often arise from the abuse of alcoholic 
drinks and the inordinate use of tobacco. Smokers and 
tipplers are peculiarly subject to them, and the absolute 
reform of these habits is essential to preserve the eyes. 
A recent writer on the eye cites twenty cases of these 
complaints. All of these patients suffered from some 
affection of the digestive and nervous system. Loss 
of appetite, constipation, loss of sleep, were common 
symptoms. Each one of the twenty patients was a 
strong smoker, and in eleven of these cases a very 
marked improvement was observed when the use of 
tobacco was given up. 





CHAPTEE IX. 

THE PREVENTION OF DECREPITUDE. 

CONTENTS. 

The chemical prevention of old age — General rules for the prolongation of 
life — The natural progress of old age — The diet of elderly persons — Physical 
exercise in old age — Preservation of warmth in old age — Mental exercise 
in old age — How to preserve the eyesight in advanced life — How to pre- 
serve the hearing — At what age to retire from business — The prevention 
of the diseases of the aged — Rejuvenation in old age. 

E have in the foregoing pages given instruction 
how to avoid many diseases : now we address 
ourselves to the even more difficult problem of pre- 
venting decrepitude, of keeping at bay the onsets of 
advancing years, and of preserving in old age some 
share at least of the vigor of middle life. The attempt 
seems a daring one, it is true, but it is not hopeless. 

Our audience now is a gray and reverend one ; we 
speak to those no longer tormented with insatiable 
passions of youth, nor oppressed with the anxieties 
and cares of middle life. "We will suppose that they 
have passed their fiftieth birthday, but have not yet 
been touched by actual decrepitude. "What plans must 
they carry out, what resolutions make, what care take, 
to postpone to the very utmost this unwished-for and 
final act in the drama of human life? 

( 285 ) 



286 THE PRETENTION OF DECREPITUDE. 

We reply, in the first place they must choose that 
diet which most effectually resists the physical changes 
which lead to decrepitude; secondly, they must pass 
their time how and where the general activity of body 
and mind is best maintained; thirdly, they must be 
on their guard against those maladies which are pecu- 
liarly fatal to the aged. 

That they may carry out the first of these directions, 
we shall speak of 



THE CHEMICAL PREVENTION OE OLD AGE, 

And shall commence with a few words on the chemical 
changes which take place in the body in advanced 
years. The bones of the aged are harder and more 
brittle, their flesh dryer and tougher, than in the young 
of the same species. This is because a mineralizing 
process is going on, and constantly increasing with 
age. There is an excessive quantity of the salts of 
lime and of carbon deposited, with a corresponding 
deficiency of water. 

In the very old, even the coats of the arteries are 
found changed into bone, the joints are dry, the tissues 
with little juice, the mineral elements of the body far 
beyond what they are in the young. 

Not only is this so, but this is the physiological defi- 
nition of old age, and could we prevent these changes, 
as Dr. S. P. Cutter has remarked, " who shall say what 
might be the outside limit of life? Who shall gain- 
say that man's organism might not be so retained in 
its youthful condition as to furnish boys and girls a 



BILL OF FARE FOR THE AGED. 287 

hundred years old? And this, by an appropriate classi- 
fication of food and drink for the different ages?" 

Without sharing the full enthusiasm of the author 
just quoted, we do believe that a "bill of fare" for 
the old can be laid down which will tend largely to 
defer the changes mentioned. 

In the first place, persons advanced in years should 
use only such food and water as do not contain min- 
eral salts in large quantities, especially the phosphates. 
Secondly, they should drink plenty of water, and prefer 
those articles of diet which are heat-producing, for 
the animal heat always flags with them. Thirdly, 
they should use freely the vegetables containing 
acids, such as fruit, salads, etc. Sugar (which 
changes to acid in the stomach), lemons, oranges, 
apples, peaches, currants, are suitable. The rinds or 
peelings should, however, be discarded, as they con- 
tain a large proportion of mineral substances. Eggs 
and milk contain the minerals in excess of almost all 
other foods. Butter and fat have little or none. 

Any vegetable acid containing hydrogen will 
decompose both the principal salts of lime in the 
system (the phosphate and carbonate), and might with 
propriety be used. 

GENERAL RULES FOR THE PROLONGATION OF LIFE. 

The dream of the alchemists, that some time or 
other some fortunate experimenter would discover the 
" elixir of life,"*of which he who quaffed would main- 
tain himself in everlasting youth, has passed away 



288 THE PREVENTION OF DECREPITUDE. 

with the countless other fancies of an unscientific 
age. "We have now learned that it is not by some 
magic potion that we can expect to prolong our years, 
but by a sedulous observation of the rules which con- 
duce to the maintenance of all our organs and func- 
tions in healthy action. This is the true and only 
recipe for length of days. 

Would we could say that these rules are generally 
known and observed ! But such is far from being the 
case. An eminent German physician was asked the 
secret of securing a long life. "I will reveal it you," 
he replied, "and in a few words : Do not shorten it." 

Under this seeming truism lies a world of signifi- 
cance. Centuries ago the sage Seneca wrote : " The 
gods have given us a long life, but we have made it 
short." And the observant critic of human nature, 
the witty La Rochefoucauld, who sums up the pith of 
many an essay in a single sentence, says: "Few 
people know enough to become old." 

Too many people accept too willingly what they 
deem the natural weight of years. They make no 
resolute effort to give battle to Time, and yield 
themselves ready victims to the threatening infirmi- 
ties of advancing age. 

This is unwise. "We have already said that com- 
parative physiology shows we all have an inborn, 
natural right to live a hundred years each, and it is a 
right we should not willingly renounce. There is no 
occasion to consider ourselves past our usefulness at 
sixty or at seventy, nor even at eighty! Among most 
recent events, have we not witnessed some of the 



THE ACHIEVEMENTS OF AGE. 289 

most stupendous undertakings ever noted in the 
world's history commenced and carried out by men 
at an age when most are contented with the chimney- 
corner ? 

In the campaign of 1870, Yon Moltke w T as seventy, 
the Emperor "William seventy-four, and the Minister 
of War in Berlin seventy-six; while the most eminent 
leaders on the other side, De Paladines and Thiers, 
were also beyond threescore and ten. Such examples 
should teach us that it is folly to yield too readily to 
the pains and aches which years, of course, bring with 
them. Let our readers, whose hairs are silvered, and 
whose faces are ploughed with the parallels of time, 
take heart, and bear in mind those mighty words 
which the poet places in the mouth of the much- 
travelled Ulysses : — 

"My mariners, you and I are old; 
Old age hath yet his honor and his toil ; 
Death closes all : but something ere the end, 
Some work of noble note may yet be done, 
Not unbecoming men that strove with gods." 

With these preliminary words of encouragement, 
we proceed to speak of the natural changes which 
occur in the bodily functions in old age, and which, 
through ignorance, are often mistaken for signs of a 
disordered condition, and hence give unnecessary un- 
easiness, and, what is worse, lead to needless and 
hurtful medication. We shall sum them up under the 
heading, 



19 



290 THE PREVENTION OF DECREPITUDE. 

THE NATURAL PROGRESS OE OLD AGE. 

The cardinal fact in this progress is the increasing 
tendency to slowness of motion. It is perceptible in 
the muscular system in walking, in the circulation in 
the weakened pulse, in the special senses in their diffi- 
cult appreciation of stimuli, in the nervous system in 
the dulness of perception, in the mind in its irresolu- 
tion and timidity. Hence it follows that we cannot 
look for the same promptitude in the various functions 
in the aged. 

Old persons often complain of constipation, and 
foolishly imagining that their bowels should act as 
frequently as in their younger days, take purgative 
medicines to move them. The practice is hurtful and 
unphilosophical. The bowels do not need to expel 
their contents so frequently, and they should not be 
forced to an unnatural activity. 

The same is true of a tendency to wakefulness. " The 
sound child-sleeping, which the thunder cannot break," 
is not the property of the aged. It has long passed 
out of their possession, along with so many other of 
childhood's joys. They cannot expect to enjoy it. 
More frequently, old people sleep less than when they 
were young or in middle life, and are induced, there- 
fore, to seek by anodynes of some kind to compel that 
slumber which refuses to be courted. This, too, ex- 
cept by the simplest means, is unwise, and sure to 
leave deleterious consequences. Opium, in all its 
forms, does not act well on the aged, and its various 
substitutes are NOT safe for habitual usage. 



THE NATURAL PROGRESS OF AGE. 291 

A marked feature in the natural progress of age is 
a greater susceptibility to cold. There is indeed a 
diminished power of producing animal heat, and con- 
sequently less ability to withstand an external low 
temperature. Hence it is that the winter months are 
so much more fatal to the aged, and exposure to severe 
weather is peculiarly dangerous to them. No fact in 
the physiology of old age is more important to the 
hygiene of that period of life than this. Every pre- 
caution should be used to avoid the consequences of a 
reduced temperature, and to supply by warm clothing 
and an even artificial heat this deficit in the natural 
caloric. To the old especially does the advice of the 
celebrated physician Boerhaave apply, who admonished 
his patients not to remove their winter clothing before 
midsummer, and to put it on again immediately there- 
after. 

Perhaps the cause of this deficiency of animal heat 
is the change in the blood. This fluid is found in old 
persons to exhibit an increased proportion of dark or 
venous blood, which signifies that it has not undergone 
its proper chemical changes in the lungs. It is also 
found that the walls of the bloodvessels become rigid 
and brittle, withstanding less securely the pressure of 
their contents, and more liable to be injured by sudden 
and violent pressure. 

This brittleness, as we have already said, extends 
to the bones. A broken limb in an old person is at 
once far more liable to occur and far more tardy in 
healing than in a child. Indeed, a fracture in a very 
aged person often never unites. The importance, 



292 THE PREVENTION OF DECREPITUDE. 

therefore, of increasing care to avoid any such acci- 
dent is very manifest. 

Having thus briefly mentioned some of the most 
prominent landmarks in the journey of life as it 
advances towards its inevitable bourn, we shall next 
make some suggestions which will pleasantly delay 
the traveller and aid in smoothing his pathway. 

THE DIET OP ELDERLY PERSONS. 

The general principles of the diet of elderly persons 
do not materially differ from those which should 
guide us at all other periods of life. They only 
require to be repeated with additional emphasis. "We 
have warned against excess at all times ; we have said 
it is injurious at every age; we add that to the old it 
is more than that, it is immediately dangerous. A 
witty French writer has well said: "The youth 
recovers in three days from the dissipation of three 
months ; the old man requires three months to recover 
from the dissipation of three days." Simply cooked, 
fresh, and varied meats, and all easily digested vege- 
tables, are always permissible. 

Some few points, however, should now receive 
especial attention. Regularity in the hours of meals 
seems in old age as in infancy, more than at other 
periods of life, essential to the well-being of the 
system. "When the digestive powers are called upon 
at stated intervals, they respond more promptly than 
otherwise. Sometimes it is wise to take food more 



A FREQUENT CAUSE OE BAD HEALTH. 293 

frequently than before. But this should never be 
done merely occasionally and irregularly. 

The loss of teeth, so common in advanced life, must 
either be supplied artificially, or else articles of diet 
should be chosen which do not require mastication, as 
soups, jellies, boiled vegetables, tender meats, fish, etc. 
We wish to direct especial attention to this point, as 
it is probably the most frequent cause of bad health in 
advanced years. It is essential that whatever food be 
taken be well chewed, and mixed with saliva before 
being swallowed. Unable to do this, very many, who 
lose their teeth when forty or fifty years of age, over- 
task their stomachs, become victims to various forms 
of dyspepsia, impair the nutrition of their bodies, and 
prepare very surely for themselves a short and wretched 
old age. 

"We have known instances w^here proper attention 
to this single admonition has converted a miserable 
invalid, fast losing hold on life, into a hale and hopeful 
man. One of the precepts for securing longevity 
which some not over-conscientious writer gives, is to 
have " a good stomach, and a bad heart." So far as 
the first half of the recipe is concerned, we are of one 
mind with its author, but we do not indorse the second 
article he recommends (by which he means an indif- 
ference to the sufferings of others). 



PHYSICAL EXERCISE IN - OLD AGE. 

It is curious that there should be any disagreement 
among intelligent physicians as to whether it is best to 



294: THE PREVENTION OF DECREPITUDE. 

take active physical exercise in old age ; yet it is true 
there is quite a discrepancy on this point. Some say 
the powers of life are longer and better maintained by 
comparative repose ; that the old should " guard their 
fires," and husband with parsimony what strength they 
still have. Others assert that the muscles may be 
longer kept in vigor by exertion, regular, universal, 
and pushed as far as may be within the limit of posi- 
tive fatigue. 

We are decidedly of this latter opinion, and feel 
sure that it is justified by the test of all opinions — 
experience. We agree entirely with an eminent au- 
thority in medical matters, who has said: "Whatever 
habits of' living sustain the greatest number of organs 
or functions in a healthy state (having regard also to 
the relative importance of these functions), may be 
considered as most conducive to length of life." It is 
better for the old to take regular daily exercise of that 
character best suited to their individual circumstances, 
but always ivithin the limits of exhaustion. 

It is of prime importance to heed this last caution. 
Fatigue, which is never desirable at any stage of life, 
is peculiarly harmful to the aged, whose recuperative 
powers are feeble, and whose bodies are very slow to 
recover from any excessive drain upon their forces. 

As years increase, the circle of exercises which it is 
proper to undertake constantly narrows, so that at 
last it may be confined to walking up and down a 
chamber. But the practice should never be wholly 
abandoned. 

Not unfrequently we see examples of vigorous old 



EXERCISE IN OLD AGE. 295 

men who, not appreciating the actual progress time 
has made, undertake exercises of altogether too violent 
and continued a nature for their forces, and who in 
consequence suddenly succumb. Let no one who has 
passed his "grand climacteric," as the ancients used to 
call the sixty-third year of life, trust too confidently 
to his powers, for a single failure may entail irrepara- 
ble consequences. 

In reference to the particular character of exercises 
which are suitable to the aged, we may lay down the 
general principle that those are most beneficial which 
draw the blood from the internal organs toward the 
extremities, such as we have specified at length in the 
chapter on exercises in general. Walking, ligbt gym- 
nastics, passive motions of the extremities, riding, 
billiards, etc., are of this character. 

On the contrary, those exercises which call into 
violent actions the lungs or heart should be scrupu- 
lously avoided, such, for example, as running, swim- 
ming, boxing, hard rowing, leaping, climbing, etc., 
and also those which call for any sudden and extreme 
expenditure of strength, as lifting, throwing, jumping, 
etc. Instances are not at all rare in the annals of 
medicine where a neglect of these precautions has 
resulted in sudden death. The condition of the luno-s 
and the heart and arteries in the aged forbids most 
positively urging them to sudden and excessive action. 
All exercises at this epoch should have precisely the 
opposite tendency, namely to equalize the circulation 
by inviting it to the surface, the skin, and the extremi- 
ties, while the internal organs are relieved in a mea- 



296 THE PREVENTION OF DECREPITUDE. 

sure of their fluid contents, and thus the dangers from 
their congestion are diminished. 

One of the most valuable effects of well-directed 
exercise is the 



PRESERVATION" OF WARMTH IN OLD AGE. 

This, as we have said, is of the highest importance. 
Exercises which call the blood to the extremities greatly 
favor it, and there are other means besides this, and 
the obvious ones of clothing and artificial heat, which 
may appropriately be employed. 

One of the most efficient of these is rubbing the 
body from head to foot every morning with a coarse, 
dry towel. Persons who are vigorous, and who have 
been accustomed to it in earlier years, will find the 
effect increased by a cold shower-bath, continued for 
only a second or two. But others should not attempt 
this somewhat violent procedure. 

ADVANTAGES OF TRAVEL. 

In this respect, a temporary change from a cold to 
a warm climate during the winter months exerts a 
permanently beneficial effect. It invigorates, and for 
a long time, the heat-producing faculties of the body. 
We cannot do better than insert here some admirable 
remarks on this point from Dr. D. G. Brinton's Guide 
Book to Florida and the South: — 

"There is an era in life when no actual disease is 
present, but when the body visibly yields to the slow 



EFFECT OF CLIMATE OK THE AGED. 297 

and certain advance of age. The mind, too, sympa- 
thizes, and loses the keenness of its faculties. "With 
most, this is about the period of sixty. It has long- 
been noticed how fatal this period is. It has also 
been noticed that it is the winter months especially 
that are dangerous to persons at this age. The old 
Romans had this pregnant expression: Hnimicior 
senibus Tiyems* — winter, the foe of the aged. Modern 
research proves its correctness. An English writer, 
Dr. Day, calculating from nearly 55,000 cases over 
sixty years of age, discovered the startling fact that 
the deaths in January were within a small fraction 
twice as many as in July. Such an unexpected state- 
ment reminds us of that significant expression of an- 
other statistician, who has studied closely the relation 
of mortality and temperature: ' Waves of heat are 
waves of life ; and waves of cold are waves of death.' 
"With these and a hundred similar warnings before us, 
we are safe in saying that in many cases two or three 
winters in a warm climate about the age of sixty, will 
frequently add ten years to life." 

This good advice we fully indorse. 

The articles of diet which are especially the heat- 
producers should not be neglected. Milk, fresh and 
warm from the cow, is one of the best. Fat, whether 
in its medicinal form as cod-liver oil, or as it appears 
on the table, should be freely eaten when it does not 
disagree. 

The clothing, of course, should be abundant, and 
chiefly of silk or woollen fabrics. 

At night, the apartment should in cold weather be 



298 THE PREVENTION OE DECREPITUDE. 

moderately warmed, and the windows always be 
closed. It is a great advantage to the aged to sleep 
with a bedfellow, healthy and much younger. The 
equable temperature thus maintained is extremely 
salutary for the senior, if not so for the junior. It has 
been remarked that those men who have attained 
extraordinary longevity, have almost without excep- 
tion married a second or third wife late in life. The 
biography of King David proves that this practical 
point in the hygiene of old age was fully known and 
appreciated by the ancient Israelites. 

MENTAL EXERCISE IK OLD AGE. 

One of the most unpleasant prospects connected 
with extreme years is the decadence of the intellectual 
faculties and special senses which is so frequently 
their accompaniment. The eye grows dim, the ear 
dull, and these two avenues to the mind thus impeded, 
that divine faculty itself loses its earlier powers and 
sinks towards a state of unconsciousness. The memory 
retains few impressions, and recalls, if anything, only 
the facts of long past years. 

Are these sad changes avoidable? "We believe they 
are, at any rate in a great measure. 

Those who fear the mental changes which they have 
seen in others, have to encourage them the examples 
of many old men who have accomplished astonishing 
feats of intellect. Buffon and Alexander von Hum- 
boldt both wrote their greatest works when long past 
seventy. Sir Isaac jSTewton when beyond eighty 



HYGIENE OF THE MIND IN OLD AGE. 299 

finished his Commentary on the Book of Daniel. Fon- 
tenelle considered his mind was never more vigorous 
than at fourscore. Dr. Samuel Johnson learned the 
Dutch language when beyond sixty. Sophocles still 
charmed the people of Athens by his poems when 
nigh eighty. An old acquaintance of ours mastered 
German when sixty- three, and lived for over twenty 
years longer in full possession of his faculties. 

These facts, and we could readily extend the list, 
hint to us the secret of retaining the mental powers in 
age. It is to use them; not to permit them to rust out, 
and become obscured from inertia. 

It may be well to point out the earlier symptoms of 
mental weakness in the aged, so that our readers may 
be upon their guard against them. One of the very 
first is a want of power in recollecting words and 
names, which becomes evident while the memory of 
facts remains still unimpaired. This is strikingly 
shown in cases of paralysis and diseases of the brain, 
and in a less degree in all who are verging upon 
mental decrepitude. 

The next step on the downward road is shown in 
the dependence of the course of ideas on the sounds 
of words. A word or phrase will carry off the mind 
to an entirely new and foreign subject without the 
consciousness of change; the conversation wanders 
from subject to subject without any other guide 
than the very slightest relation of time or space, or 
than some sound which evokes the memory. This is 
the explanation of the garrulous and vague talk of the 



300 THE PREVENTION OE DECREPITUDE. 

old, and depends upon their loss of power to follow 
out a connected train of ideas. 

These symptoms indicate the two principal points 
in mental exercise which should engage the attention 
of the old. They should correct them by making a 
particular study of names and words. For this, 
nothing is equal to acquiring a new language, or 
studying some natural science which demands a 
familiarity with new and unknown terms and appella- 
tions. Secondly, they should make a particular effort, 
in conducting a conversation or in writing a letter, 
always to bear in mind the leading topic to be dis- 
cussed, and resolutely avoid any digressions from it. 

Another peculiarity of the mind of the aged is that 
the impressions of the present are much less vivid 
than those of former years. Many old people can tell 
with accuracy the events of half a century ago, but 
hardly remember what transpired last month, or the 
contents of the last book they read. This is not so 
much a defect of memory, as it is a want of attention 
to what is going on around them. They are indifferent 
to the present, and dwell in thought chiefly upon the 
past. In other words, it is a bad habit which ought 
to be broken or never allowed. It has universally 
been remarked that those who enjoy a "green old age" 
retain a fresh and vivid interest in the matters of 
daily life. This is as much and more the cause than 
the consequence of their mental vigor. 

The time never comes in the life of a man or a 
woman, when he can seclude himself from the world, 
and bid farewell to its pleasures and its sorrows. On 



HYGIENE OF THE MIND IN OLD AGE. 301 

the contrary, it becomes "very stuff o' the conscience" 
for the aged to busy themselves with the present and 
"let the dead past bury its dead," for thus alone can 
they hope to retain the full powers of life. The old 
should seek the company of the young, as the young 
should prefer that of the mature. 



TEMPER AND EMOTION. 

Apart from these rules of mental training, the dis- 
position and temper have much to do with the comfort 
and prolongation of life in the aged. Cheerfulness 
and serenity, laudable at all ages, here become neces- 
sary. Sudden emotions, whether of joy or grief, vio- 
lent passions, and acute sensations are condemned by 
the voice of nature herself, who, aware of the fragility 
of the golden bowl of life in the aged, blunts their 
sensibilities, and instils an inclination to calmness 
and impassiveness. 

What the old more especially have to strive against 
is not strong emotion, but groundless anxiety, timidity, 
irritability, melancholy, and parsimony. These are 
their mental vices, and these they should deliberately 
encounter. The promises of religion should sustain 
and comfort them, they should cultivate habits of 
agreeable social intercourse, they should relax rather 
than tighten their grasp on that treasure which they 
can hope to enjoy for only a few years more, and they 
should aim to set before others an example of fortitude 
and resignation under the inevitable ills to which they 
are subjected. 



302 THE PREVENTION OE DECREPITUDE. 



HOW TO PRESERVE THE EYESIGHT IN ADVANCED LIFE. 

Every one knows that most persons between the 
age of forty and fifty have to commence wearing spec- 
tacles, or at any rate to compromise the matter by the 
occasional use of the eyeglass. 

The eye is affected in the reverse of what it is in 
near-sighted persons. In these the ball is too convex, 
in the old it becomes too flattened. They can see 
more distinctly at a distance than close at hand, and 
are therefore familiarly called "long-sighted." 

The strength of the eye also becomes impaired, and 
its ability to do full labor diminished. The precau- 
tions to avoid this condition should begin early. The 
light in which persons read or sew or do any work 
requiring close sight should be neither very bright 
nor yet dim ; the eyes should always be rested when 
they feel fatigued; they should not be tasked in the 
twilight nor when lying down ; they should be freely 
bathed with cold water or salt-water every morning; 
and when injured or inflamed, skilled advice should be 
had early. From the time the earliest symptoms of 
long-sightedness appear, the following simple proce- 
dure should be observed several times a day, and will 
be found to be very efficacious in retarding the 
advance of the complaint. Pass the fingers several 
times over the closed eyes with a gentle equable pres- 
sure, always commencing from the outer angle and 
proceeding toward the bridge of the nose. This pre- 
vents the flattening of the surface of the eye, which is 
the cause of the impairment of sight. 



TO AVOID THE DEAFNESS OF AGE. 303 

When the sight is already impaired, it is much 
better to provide a pair of spectacles of a low power 
than to do violence to the organs by efforts to dispense 
with these valuable though unwelcome aids. 



HOW TO PRESERVE THE HEARING-. 

The deafness with which elderly people are often 
annoyed proceeds in some cases from an absolute want 
of nervous power, and in these cases nothing can be 
done. But in a large number it is dependent on pre- 
ventable causes. The commonest is an accumulation 
of wax in the ear. Even if this is not in sufficient 
quantity to choke up the avenue, it may give rise to 
slow inflammation, which can result in incurable deaf- 
ness. It is a prudent precaution, therefore, to have 
the ears examined by an expert physician every few 
months, and any accumulation of wax carefully re- 
moved. We do not recommend persons to attempt 
this for themselves, even by such an apparently simple 
process as syringing their own ears, for it is very easy 
to do serious damage to this delicate organ by slight 
carelessness or awkwardness. Moreover, many will 
think they have cleaned the ear nicely, when in fact 
they have not even loosened the impacted wax. 

A frequent cause of impairment of the hearing is 
the abuse of tobacco. This powerful drug seems to 
act with peculiar force on the organs of special sense, 
and leads to singing and roaring sounds in the ear and 
to deafness. The old, who insist on continuing its use, 
should at least do so in great moderation. 



304 THE PREVENTION OF DECREPITUDE. 



AT WHAT AGE TO RETIRE FROM BUSINESS. 

Physicians are often asked this question. The cus- 
tom of our country is such that when a man reaches 
sixty or sixty-five years of age, it is expected that he 
will withdraw from the active participation in business 
affairs, and pass the rest of his life, if able, in doing 
little or nothing — taking care of his investments, if he 
has any. The consequence* of this generally is, that 
the old man, deprived of his customary objects of 
interest, and with no social or literary resources to fall 
back upon, soon grows irritable and mopish, fancies 
his health is breaking down, sets to work to improve 
it by elaborate cares and medication, and worries him- 
self into his grave years before his time. The fatality 
among men " retired from business" has often been re- 
marked, and this is its explanation. 

Nevertheless, our advice is not to remain immersed 
as deeply as ever in the toil of affairs. It is better, 
gradually, as age advances, to diminish the pressure, 
to avoid great risks, and escape tormenting anxieties, 
by confining and lessening one's enterprises. More 
time should be given for travel, rest, and recreation. 
An interest should be cultivated in public affairs and 
in works for the public benefit. But some direct per- 
sonal interest in the transactions of daily life, in the 
sphere to which we have been accustomed, should ever 
be retained. 



NO DEATHS FROM OLD AGE. 305 

THE PREVENTION OF THE DISEASES OF THE AGED. 

We have before remarked that each epoch in human 
life is exposed more particularly to certain diseases, 
and the fatality at any given period is found pretty 
uniformly to be due to the same maladies. Hence it 
is an important part of hygiene to point out to what 
diseases we are most exposed at various ages, and to 
inform us by what means we can most successfully 
avoid them. 

From the age of fifty upward, the mortality chiefly 
arises from apoplexy, inflammation of the lungs, 
cancer, chronic bronchitis, and diseases of the heart. 
Deaths are frequently sudden, the system requiring 
little to break it down. The precautions necessary to 
prevent these diseases we have already given in part, 
and shall refer to some of them again when we come 
to treat of " Sudden Death." 

Death from " Old Age," although it appears on the 
mortality records, has in fact no existence. The mere 
great age of a man does not destroy. The grass- 
hopper may become a burden to him, but it requires 
some definite cause to stop the sluggish stream of his 
life. The gradual failure of the physical powers 
which carries off many old people is usually a defect 
of nutrition; the stomach no longer does its duty, 
and they die of inanition — of a painless starvation. 

REJUVENATION IN OLD AGE. 

A curious physiological fact almost encourages us 
to hope that some day or other the true elixir of life 

20 



306 THE PREVENTION OF DECREPITUDE. 

may be found which will renew youth in worn-out 
frames. For nature herself strives to do this in some 
instances. 

Sir Walter Scott, when growing infirmities made 
him speak of himself playfully as coming round to 
the starting-point of life again, said he wished he 
could cut a new set of teeth. Although unaware of 
it, he did not wish for an impossibility. In quite a 
number of instances of great age it has been remarked 
that persons in their seventieth and eightieth years, 
when others cease to live, acquire new teeth, and new 
hair, not gray, but the color of that they had in youth. 
Their sight, previously failing, improves, and they 
can discontinue spectacles. Their hearing becomes 
more acute, and they commence a new period of life 
which may last from ten to thirty years. 

Did we only know what it is in the system which 
brings about this pleasant restoration of the facul- 
ties, we might cultivate it, and, by applying the 
proper means, see our venerable sires roll back "the 
onward flowing tide of time" and resume the strength 
and looks of their younger days. 

An English lady, named Susan Edmonds, who died 
a few years since at the age of 105 years, recovered 
her natural black hair when ninety-five years old. 

The restoration of the sight of aged persons is by 
no means uncommon, and is familiarly known as 
"second sight." There was an ancient superstition 
in Scotland that such persons could see the spirits of 
the departed, and hence the phrase came to have a 
supernatural significance also. 



THE SECOND YOUTH. 3Q7 

Dr. Hufeland relates that he knew an old magistrate 

on the Rhine who lived to the age of 120 years, who 

in the last ten vears of his life had several sets of 
</ 

teeth. As fast as they dropped out, which they did 
without pain, nature supplied him with a new set. 

Reflecting upon such examples, we see that the 
second childhood of the aged may be the prologue to 
a second youth. 







CHAPTER X. 

ON DEATH. 



CONTENTS. 



The fear of death— Sudden death— The signs of approaching death — The last 
words — Presentiments of death — Buried alive — Deceptive appearances of 
life — Tests of actual death. 



B have spoken of Life and of Health — joyous 
themes, which all dwell upon with delight, 
which we fain would part from never, of which we never 
have enough. Now, however, it devolves upon us to 
speak of Death, the period and terminus of life, the 
grievous theme associated with all that is dark and 
dreadful to the fancy. 

Our purpose is not merely to discuss it with the 
cold language of science, but to divest it, if possible, 
from some of the horrors which surround it. For, as 
Montaigne says, "He who should teach men to die, 
would teach them to live." And, first, to say some- 
thing concerning 



THE FEAR OF DEATH. 

In not a few instances we have known the dread of 
death destroy the joy of life and sour the cup of plea- 
sure with the fearful looking for its inevitable termi- 
nation. The strongest minds do not rise superior to 
( 308 ) 



TO AVOID THE FEAR OF DEATH. 309 

this. Dr. Samuel Johnson, the lexicographer, was 
haunted all his life by this apprehension, philosopher 
and Christian though he was. 

The ancients courted this thought — strange as it 
seems to us — to add zest to their pleasures. At their 
feasts a skeleton or a faithful image of a corpse was 
placed in the banquet hall, that the guests thus grimly 
reminded of the brevity of life, should hasten to suck 
all its sweets. "Eat, drink, and be merry, for to- 
morrow ye die," was the sermon this ghastly monitor 
preached to them. 

Hardly wiser than they, we banish with sedulous 
anxiety from our social life and our daily conversation 
all reference to the fact of death. "We employ circum- 
locutions and metaphors to express our meaning, and 
say of a deceased friend, " He has passed away," or " He 
has fallen asleep." 

This not merely discloses, it actually fosters, the 
sentiment of dread which is entertained toward death. 
The opposite plan should be adopted. "We should not 
banish, but familiarize ourselves with the thought of 
our fate. The philosopher Descartes devoted five 
minutes every day to the contemplation of his own 
death, considering how near it might be, how certain 
it was, how calmly he should meet it, and how he 
should prepare himself for it. By thus becoming 
familiar with the idea, it lost to him all its terrors. 

"We believe his plan excellent. And to assist fur- 
ther those who would thus courageously look in the 
face of the worst that destiny can do, we bring some 
consoling facts from medical experience. 



310 ON DEATH. 

Two sentiments give contemplated death its sting — 
the love of life, and the fear of suffering in that mortal 
agony. 

THE LOVE OF LIFE. 

To the young, the happy, and the strong, the 
thought of death is indeed loathsome. But let them 
remember it is different when the body is racked with 
pain, when the flowers of life have withered, when the 
power of enjoyment has passed. They will not feel 
that strong desire to "live; they will look with calm- 
ness, perhaps with pleasure, to the abandonment of 
earth ; they will become 

"Too satiate of life, to strive with death.'* 

The eminent physician, Sir Henry Holland, beauti- 
fully says on this point: "'No previous reason or 
feeling, no judgment of vigorous health, can afford a 
right estimate of the relation the mind assumes to 
death in the latter hours of life, even where little im- 
pairment of the faculties has occurred. This is espe- 
cially true when long and painful sickness has been 
the prelude to the event. The earnestness to live 
abates as the possession of life is gradually with- 
drawn." 

The young need not fear, therefore, to have to 
strive with that warm and pulsating delight of exist- 
ence which is now theirs. By a beneficent arrange- 
ment of nature, the mind is prepared for its inevitable 
change. 



THE SENSATIONS OF THE DYING. 311 



THE PAIN OE DEATH. 

In regard to the second cause of fear, medical men 
are universally of opinion that the pain of dying is 
not great. Some, indeed, maintain that the sensation 
is a pleasurable one. They base this opinion on the 
well-known fact, that in cases of sudden death, as on 
the battle-field, the expression on the face of the 
corpses is usually soft and calm — not as if the last 
sensations had been painful, but the reverse. Then, 
also, it is no uncommon sight to witness a pleasurable 
expression pass across the features of a person dying 
of some slow disease. In some, whose countenances 
have been distorted by the pain and peevishness of 
long illness, the original mildness of features re- 
appears at this moment. 

On the other hand, in most sudden and violent 
diseases, such as fevers and cholera, the person sinks 
into a state of stupor for hours or days before death, 
so that sensation is lost or impaired, and neither fear 
nor pain can be felt. Consequently, so far as the 
physical fact of death is concerned, it is, so far as we 
can judge, not of a character to inspire terror. 

Further evidence to this effect is given by the last 
words of the dying. These lead us to believe that 
the sensation is not a painful one. Thus the eminent 
London physician, Dr. "William Hunter, said in his 
last moments: "If I had strength to hold a pen, I 
would write how easy and pleasant it is to die." The 
Lady Glenorchy's last expression was: "If this be 
dying, it is the easiest thing imaginable." Louis 



312 ON DEATH. 

XIY., as he felt himself passing away, whispered: 
"I thought that dying was more difficult." His 
words were not unlike those of the aged Fontenelle, 
who at the ripe age of a hundred years was on his 
dying bed. An anxious friend asked him if he suf- 
fered. "I feel no pain," was his reply, "only the 
difficulty of living." Those who have been rescued 
from drowning or hanging at the very last moment 
before life was extinct, nearly all state that they did 
not suffer after the first shock. 

We may conclude this topic by recommending to 
our readers the eloquent passage in the Spectator, in 
which Addison speaks of this theme as follows : — 

"I know but one way of fortifying my soul against 
all gloomy presages and terrors of death, ,and that is, 
by securing to myself the friendship and protection 
of that Being who disposes of events and governs 
futurity. He sees at one view the whole thread of 
my existence ; when I lay me down to sleep, I re- 
commend myself to his care ; when I awake, I give 
myself up to his direction. Though I know neither 
the time nor the manner of death I am to die, I am 
not at all solicitous about it, because I am sure that 
He knows them both, and that He will not fail to 
support and comfort me under them." 

SUDDEN DEATH. 

Some physicians, and many who are not physicians, 
believe that sudden death is more common now than 
formerly. It is peculiarly terrifying, and, for the sake 



TO AVOID SUDDEN DEATH. 313 

of those dependent upon a person's care or labor, most 
desirable to avoid. In the sublime litany of the Eng- 
lish Church, one of the prayers is for "deliverance 
from sudden death." Its causes, therefore, deserve 
our close attention, with a view to see if they may not 
be avoided. 

When a person drops dead in the street, every one 
at once attributes it to "heart disease." Very few of 
such occurrences really arise from this cause. Heart 
diseases, as a rule, are slow in their effects and in their 
termination. The real origin of sudden deaths has 
lately been very carefully examined by scientific men 
in Europe and this country. A number of cases 
have been thoroughly studied, and with valuable re- 
sults. 

For example, out of sixty-six cases of sudden death, 
in which the bodies were examined by expert anato- 
mists, only two were found to have died of disease of 
the heart. Nine had died from apoplexy, while in the 
large majority, forty-six out of the sixty-six, the cause 
of death was congestion of the lungs, that is, the lungs 
were so full of blood they could not perform their 
proper work. 

"Wherever these investigations have been repeated, 
pretty much the same results have been obtained. Of 
course, we here leave out of account accidents, such 
as sunstroke, which annually destroys many in our 
climate. The two chief causes, therefore, remain con- 
gestion of the lungs and apoplexy, and it is gratifying 
to know that both these can, to a great degree, be 
avoided by proper precautions. These, so far as apo- 



314 ON DEATH. 

plexy is concerned, we have already recapitulated on 
a preceding page. The principal causes that produce 
congestion of the lungs are cold feet, tight clothing, 
costive bowels, sitting till chilled after being warmed 
by labor or an active walk, going too suddenly from 
one extreme of temperature to another — as, in winter, 
from a heated room into the cold air, or the reverse — 
long and loud speaking, sudden and violent emotion, 
whether of grief or joy, and exposure to damp cold. 

As sudden death from accident or disease may occur 
to any one and at any age, it is a wholesome prudence 
to set and keep our houses in order, ever prepared, in 
the words of a wise adviser, to die to-morrow, or to 
live a hundred years. The church historian Meander 
was one who successfully cultivated this happy frame 
of mind. Asked, one day, what he would do, were he 
certain to die the next day, he replied, he would deliver 
his customary lecture on ecclesiastical history. 

Sudden death was esteemed by the ancients a blessed 
and fortunate fate. Julius Caesar, by a strange coinci- 
dence, the day before his assassination in the Capitol, 
expressed the wish that he might die suddenly when 
death did come. The same desire was common to the 
naturalist Pliny and the Emperor Augustus. The 
essayist Montaigne, who seems to have been posi- 
tively haunted by the fear of death, agreed with them, 
saying that as he must swallow this bitter pill, he pre- 
ferred to do it without chewing ! He evidently was 
of one mind with the old English writer Thomas 
Fuller, who, after discussing the various modes of 
death, slow and sudden, violent and natural, finishes 



THE PICTURE OF NATURAL DEATH. 315 

with the brief conclusion, "None pleaseth me!" The 
majority of our readers will doubtless agree with him. 

THE SIGNS OF APPROACHING DEATH. 

Every one is called at some period of his life to 
stand beside the death-bed and witness its solemn 
scenes. Often it becomes of the utmost importance to 
judge how soon the end will come and to recognize 
its approaches. We shall draw the picture as it 
presents itself to the view in natural death. 

The patient lies exhausted, the strength gradually 
yields, convulsive tremors slightly move the muscles, 
the pulse beats feebly and irregularly, the breathing is 
also irregular and gasping, and the breath drawn with 
difficulty. Often some phlegm obstructs the air in 
the windpipe, causing a gurgling sound, which is 
familiarly known as "the death rattle." The tempera- 
ture lowers, the hands and feet growing perceptibly 
colder. The features become drawn and rigid, the 
nose contracts and sharpens, the eyes become glazed 
and fixed, and the limbs outstretched. The senses 
grow dull, first the sight, next the hearing. 

"While it is not common, it is not very rare to 
witness a strange brightening of the intellectual 
powers a few hours before death. Insane persons have 
been known all at once to recover their reason a short 
time before their decease, and very old persons, who 
for years had passed into their second childhood, 
resume their earlier powers. 

Medical wisdom is unable to explain this wonderful 



316 OX DEATH. 

change, though it has long been observed. Even the 
ancient classical writers refer to it. Cicero speaks of 
it in one of his essays, and adds the explanation: "As 
death approaches, the soul puts on its divine nature ;" 
and Plutarch likewise discusses it. To us, this occa- 
sional resumption of its lost faculties at the time of 
its separation from the body, is a proof that the mind 
of man lives another and a higher life beyond the 
grave, and, though temporarily obscured by the frailties 
of its fleshy habitation, in no wise partakes of those 
frailties, but is fitted for an independent and immortal 
existence. 

The readers of Cervantes' immortal romance, Don Quixote, 
will remember that the hero, when on his death-bed, becomes 
fully aware of the latent insanity which has characterized his 
acts, and renounces the folly of his knight-errantry. The 
sketch is drawn with the fidelity of nature by a master-hand. 

A similar apparent change for the better is frequent 
in several severe diseases, as hydrophobia, and inflam- 
mation of the brain. The fever lessens, the delirium 
subsides, the pain departs, and the attendants, some- 
times even the physician, are led by these deceptive 
signs to believe that the crisis is past. When inflam- 
mation of a part passes into mortification, the pain, 
which before has been almost unbearable, suddenly 
leaves, and the patient is comparatively comfortable, 
and even cheerful. But a few hours show that the 
lull and rest are but the premonitions of the everlasting 
rest of death. 

The French mathematician Charleval was attended in his 
last illness by two physicians. As they entered the room one 



THE MEANING OF DYIK'G- WORDS. 317 

day, the younger noticed that the patient seemed in every re- 
spect easier, and, anticipating a speedy recovery, exclaimed to 
his associate: "Look, doctor! the fever is going." "No!" 
replied his older and wiser companion, " it is not the fever that 
is going, but our patient." 



THE LAST WORDS. 

Many persons have found a pleasure in collecting 
the last words spoken by the departed, and it has been 
thought that possibly from them some hints might be 
gleaned of the unknown hereafter. But the physician 
who watches by many death-beds soon becomes con- 
vinced that, when intelligible at all, they either indicate 
a rambling mind or refer to the physical changes that 
are taking place, or to emotions and sentiments long 
familiar to the individual. They may afford matter 
for the curious, but can throw no light on the future. 

As death approaches, the eyes lose the power of 
vision, and the apartment seems to grow dark. Often 
the dying words refer to this, as those famous ones of 
Goethe's, " Light, more light" (Z/icht, melw UcJit). So 
Dr. Adams, the author of " Adams's Roman Antiqui- 
ties," and for many years principal of a large school, 
said in his last moments : " It is growing dark. The 
school is dismissed." Here we perceive the intellect 
was wandering, and the schoolmaster thought himself 
once more engaged in his favorite occupation. Such 
was also the case with Napoleon, who imagined him- 
self once more on the battle-field, and dying, muttered 
u Tete ctfarmee;" and with Frederick the Great, whose 
mind reverted to his long and arduous marches, and 



318 OK DEATH. 

said "La montagne est pasee, nous irons mieux" (We are 
over the hill, we shall go better now)." Daniel "Web- 
ster's last words, so full of meaning, " I still live," 
were spoken as he recovered from a deep faint, and 
were no doubt a conscious utterance, intended to reas- 
sure his friends. 



PRESENTIMENTS OF DEATH. 

There are riot a few authentic instances on record 
where persons have foretold with precision the period 
of their own death. False presentiments of this kind 
are, however, far more common, and any such gloomy 
feelings should be resolutely combated and banished. 
"We have known persons, and some young and vigor- 
ous, who made themselves wretched for months, be- 
cause they imagined they would die at a certain time. 
Such feelings are false and dangerous. 

Persons have died because they made up their minds 
that they must die: and, under any circumstances, to 
indulge such a belief is unwise, depressing, and need- 
less. 

In cases of long sickness, prostration, and great age 
such presentiments may be regarded as intimations 
of serious though perhaps unobserved changes in the 
system. This is the explanation given by the eminent 
anatomist and surgeon, John Hunter. " We feel," he 
says, " that we shall not live, for the powers of living 
become weak, and the nerves communicate the fact to 
the brain." 

John Hunter himself was a striking example of the 



PBESEXTIMEXTS OF DEATH. 319 

fact he thus explained. He was well aware that he had 
a disease (aortic aneurism) which might any day 
cause his death. As he went to the hospital one day 
to discuss a scientific question, he remarked that if he 
became excited, he would die that morning. The con- 
troversy, as he feared, became heated, and, as he pre- 
dicted, he fell and never rallied. 

Still more remarkable was the case of the painter 
Hogarth. Feeling his powers decreasing, he set to 
work upon a strange and weird picture. A friend, 
gazing at it with astonishment, asked its name. " The 
end of all things," replied the artist. ""Why, then," 
jokingly replied the gazer, "the painter will end too." 
"I know it," said Hogarth, gloomily; "it is my last 
work." A few weeks after it was finished he was 
dead. 

The mathematician Ozanam was a well-known 
teacher in Paris some years ago. At the commence- 
ment of one term, while apparently in perfect health, he 
refused to take any pupils, on the ground that he would 
not live to the close of the session. His mind was 
thought to be affected, but, true to his presentiments, 
he died in a few months. 

BURIED ALIVE. 

Every few months some harrowing narrative of pre- 
mature burial goes the rounds of the papers, and 
hundreds of readers are tormented night and day with 
a horrible fear lest they should be the victims of some 
such dreadful mistake. "We feel it a duty to reassure 



320 OK DEATH. 

them as much as possible on this point, and shall do so 
in two ways : first, by showing how extremely rare and 
improbable any such accident must be; and, secondly, 
by giving such a number of tests of actual death, that 
any one can determine positively that the spirit has 
forever departed. 

The stories referred to do not bear any examination. 
!N"ine in ten are utterly fictitious, and the tenth rests 
on misunderstood facts. It is well known that during 
the decomposition of the body gases are produced 
which may disarrange the clothing, and even turn the 
body by their expansion. Any such motion, when 
discovered, is erroneously attributed to voluntary 
action after burial. 

As for actual instances, they are exceedingly rare. 
In Munich and at Frankfort-on-the-Main they have 
for many years been accustomed to keep the bodies of 
those dead, or supposed to be dead, for a certain 
number of days, to prevent premature burial. "Wires 
are fastened to their wrists, and attached to these are 
alarm bells, so that the slightest movement would 
call assistance. Means of restoration are at hand, 
ready for any signal. Although for many years these 
precautions have been taken, only one instance of 
mistaken death has been known in Munich, and none 
whatever in Frankfort. 

Novel- writers love to depict the similarity of trance, 
or catalepsy, to death, and to represent them as mis- 
taken, the one for the other. Such occurrences 
belong wholly to the realm of fiction, and need give 
no uneasiness. The only possible liability of error 



PREMATURE BURIALS RARE. 321 

would occur where iu sudden and violent diseases, as 
in cholera, the body is hurried to the grave, supposed 
to be lifeless but really in the condition known as 
collapse. But it is doubtful whether even this has 
ever occurred. In fine, with ordinary precautions, 
there is not the slightest danger that such a mistake 
could occur, and solicitude about it, either for ourselves 
or others, is entirely unnecessary. 

A French writer, some years since, collected together 
all the alleged cases of premature burials on record. 
They were less than a hundred in number, and not 
one-tenth of them in any degree authenticated. 

There have indeed been a few cases where a fainting- 
fit was hastily concluded to be death. A famous one 
was that of the Abbe Prevost, the author of the 
charming romance "L'Histoire de Manon L % Escaut" 
Returning from a long walk to his house, he fainted, 

O O 7 3 

probably from fatigue. An ignorant surgeon was 
summoned, who pronounced him dead. and. in order 
to ascertain the cause of his sudden decease, pro- 
ceeded to open the body. The pain brought the 
Abbe to his senses, but the incision proved fatal! 

A Frenchman, by name Civile, gained considerable 
notoriety by always signing his name with the addi- 
tion : "Thrice dead, thrice buried, and thrice restored 
to life by the grace of God." But an examination 
of his story, which was probably true, showed that he 
was merely left for dead on the battle-field that often, 
and never actually buried. 

Several extraordinary instances are, however, on 
record, where, by a voluntary effort of the will, persons 

21 



322 OX DEATH. 

could throw themselves into a condition which even 
practised medical men could not distinguish from real 
death. One of the most famous is that of Col. 
Townshend, an English gentleman who lived in the 
last century. On one occasion, in the presence of 
three physicians, and merely to gratify their curiosity, 
he illustrated this strange power by passing into a 
state so closely resembling death that they could not 
discover a sign of life for half an hour, and concluded 
that he had at last pushed his experiments too far. 
To their surprise, after that interval, he returned to 
his full powers. There can be no doubts either as to 
the fact nor as to the skill of the physicians who 
examined him. 

One of the Oriental sects of religious fanatics em- 
braced in Brahmanism have, for centuries, made the 
attainment of this power of suspending visible life the 
highest proof of virtue, and, therefore, the object of 
greatest ambition. It is related of one of their recent 
teachers that " so eminent was he in the practice of 
the divine commands, that he could suspend his breath 
for four-and-twenty hours." 

But even this model of virtue was surpassed by one 
of the East Indian fakeers, who threw himself into a 
trance, was buried for forty days, and his tomb watched 
night and day by a guard of English soldiers, and, 
after all this, was restored by the skilful manipulation 
of his servant ! Yet this narrative reaches us on tes- 
timony that seems to admit neither of falsity nor error. 

With these possibilities before our eyes, we natu- 
rally desire to know what are the signs of actual death; 



FALSE SIGNS OF ANIMATION. 323 

for although mistakes to the extent of burying the 
quick for the dead almost never occur, we wish to place 
them entirely out of the pale of possibility. 

Before proceeding to these signs, however, we wish 
to acquaint our readers with certain 

DECEPTIVE APPEARANCES OF LIFE, 

Which are not unfrequently observed after actual death 
has taken place, and which, when misunderstood, give 
rise to the most painful anxieties on the part of friends, 
and perhaps injurious comments by spectators. The 
first of these is 

CONTINUED WARMTH OF THE BODY. 

Sometimes, especially after violent fevers, the body 
is actually warmer for some hours after death than it 
was during life. This is frequently seen in yellow 
fever, and probably it depends upon the rapid changes 
toward decomposition which are taking place. At the 
expiration of about twenty-four hours this heightened 
temperature disappears. 

COLOR IN THE CHEEKS. 

That the roses of health should bloom upon the 
face of death, is indeed a strange phenomenon ; yet it 
is not unusual. Sometimes, instead of the dusky 
pallor and lividity which we generally see on the coun- 
tenances of the departed, we note a flush and color 
which emulate the roseate hue of youth and vigor. 



324 OK DEATH. 

The cause of this is the mode of death. "When it is 
of such a character as to leave the small bloodvessels 
of the skin filled with blood, instead of draining them 
back toward the heart (as is usually the case), the red 
color of the vital fluid is seen on the surface after the 
spirit has departed. "When the other signs, which 
we shall shortly rehearse, prove that the great change 
has come, this illusory show of life need never be re- 
garded. 

MUSCULAR MOVEMENTS. 

The muscular changes which occur at death are 
two: first, in the agony itself, a complete relaxation 
of all the limbs; and, secondly, some hours after, 
averaging from three to twelve, commences a stiffness 
of the muscles over the whole body, called the "rigidity 
of death." This latter is not unfrequently accompanied 
by slight contractions, which may distort the features, 
move the corpse, or even force it into strange and 
striking postures. A physician, who had an extensive 
experience in a hospital during a violent cholera epi- 
demic in one of our large cities, states that he had 
several times observed that the corpses of those who 
had perished with this formidable disease had the arms 
drawn and contracted into the attitude of prayer ! To 
superstitious minds this would have passed as a 
miracle ; in an unenlightened community the presump- 
tion would have been that death was only apparent; 
but to the trained and scientific observer it was only a 
singular illustration of the contraction of muscular 
tissue after death. Motion may also take place after 



A FALLACIOUS TEST. 325 

decomposition has commenced, caused by the devel- 
opment of gases in the body. The physicians to the 
Morgue in Paris, where unknown corpses are left for 
recognition, say it is no unusual occurrence for them 
to roll off the tables, and they occasionally have to tie 
them to the slabs on which they repose. 

BLEEDING AFTER DEATH. 

As a rule, at death the blood is withdrawn from the 
arteries and coagulates in the veins. But this is not 
invariably the case, as it is the peculiarity of some 
diseases that they cause a change to take place in the 
vital fluid which retains it in its fluid condition. 
Hence, it is possible that for many hours after death 
has actually occurred, blood will flow from a cut, or 
on moving the body. It is a purely mechanical phe- 
nomenon, which should excite no astonishment. 

In ancient times, when a person was killed by 
unknown hands, the suspected murderer was forced to 
lay his hand upon the body, when it was believed that, 
were he guilty, the corpse would bleed afresh. As 
blood did occasionally flow from the wound under the 
pressure of the hand, some lost their lives by this 
fallacious test, which was the worse chosen, because 
the innocent would be more apt to press firmly than 
the guilty. 



326 OX DEATH. 



TESTS OF ACTUAL DEATH. 



A wealthy Frenchman, haunted perhaps by a horror 
that he should one day be buried alive by mistake, not 
long since offered a prize of twenty thousand francs 
for the discovery of a simple, infallible, and readily 
applied test of death. It is true enough, as may be 
judged from this, that we have not long been in pos- 
session of any such test. The usual signs of death 
are, no doubt, all of them open to error. 

The pallor of the face may be absent, as we have 
above remarked, and is present in collapse and other 
conditions where life is not extinct. 

The coldness of the shin may also be absent in death, 
or present in life. 

The rigidity of the muscles in death is very closely 
simulated by the convulsive rigidity in certain nervous 
diseases, and by stiffness from great cold. 

The absence of breathing, if absolute, undoubtedly 
means death. But it cannot be denied that persons 
may live by breathing so gently and inaudibly that a 
bright mirror before the mouth will not be moistened, 
nor the flame of a candle caused to flicker, nor a shred 
of down swayed to and fro by the breath, nor any 
heaving of the chest be visible. 

So also the pulse may cease at the wrist and in the 
neck, and the throbbing of the heart be no longer 
detected, and the soft murmur of the hurrying blood 
be no more audible, and yet life may be there. 

Is there, then, any absolute, simple, readily applied 



TESTS OF ACTUAL DEATH. 327 

test of actual death? "We now perceive that the indi- 
vidual who offered a handsome sum for the solution of 
this question appreciated correctly the importance of 
ascertaining one which might be made familiar to all, 
and which would forever prevent the recurrence of 
the horrible casualty of premature burial. Naturally 
enough, his liberal offer has stimulated physicians 
to devote unprecedented attention to this point, and 
several tests have been discovered, each said to be in- 
fallible, and which taken together, certainly are infalli- 
ble. "We proceed to enumerate them. 

THE BLISTER TEST. 

Every one knows that if an iron at dull red heat be 
brought in contact with the skin during life, a blister 
is at once raised upon the surface. On the contrary, 
if the same application is made to a corpse a few hours 
after death, no blister whatever is caused, but the sur- 
face is only burnt and charred. 

THE NEEDLE TEST. 

If a brightly polished steel needle is plunged into 

the flesh of a living animal and withdrawn after a few 

minutes, it will shortly become tarnished and rusted. 

But if inserted into a dead body for the same length 

of time and withdrawn, it will retain its polish 

altogether or for a much longer time. 

Both these experiments depend for their explanation upon 
the fact that the fluids in the corpse rapidly pass off into 
the atmosphere, and, therefore, in the first case, there is no 



328 ON DEATH. 

serum to form a blister, and, in the second, comparatively 
little moisture to tarnish the steel. 



THE EYE TEST. 

The tincture of belladonna (deadly nightshade) has 
the curious power, when a few drops of it are applied 
to the eye during life, to cause an enlargement of the 
pupil, owing to the production of a contraction in the 
muscles which surround it. But after the extinction 
of life, the muscles do not respond to this stimulant, 
and therefore when it is applied and no effect is pro- 
duced, we may conclude actual death has taken place. 



THE EYE SPOT. 

Several hours after death, if the eye is closely ex- 
amined, it will be found to present a peculiar dis- 
coloration, never witnessed during life. It appears in 
the white of the eye, on the outer side of the pupil, 
as a dark spot. It then shows itself nearer and nearer 
the inner corner, draws closer to the centre of the 
organ, and at last forms an oblong rounded spot on 
the lower convexity of the eye. "When present, it 
may be regarded as an absolute proof of death. 

This, too, is to be explained in the same manner as 
the first two tests we have mentioned. The outer 
coat of the eye drying after death more rapidly where 
it is exposed to the air, and no longer receiving the 
fresh supply of moisture with which it was fed during 



TESTS OF ACTUAL DEATH. 329 

life, becomes transparent, and the dark internal coat 
(choroid) can be more or less distinctly seen through it. 

DECOMPOSITION". 

Finally, the absolute and indisputable sign of death 
is decomposition. This first manifests itself by a dis- 
coloration of the surface on the stomach, and by a 
peculiar and unmistakable odor. It sets in at various 
periods, from a few hours to many days, depending 
upon the temperature, the disease which carried the 
individual off, and the surroundings. 





CHAPTER XL 

THE DISPOSAL OF THE DEAD. 

CONTENTS. 

The mortal remains — The care of the corpse — The rigidity of death — How 
long a body should be kept — How to preserve a body: By cold — By the 
external use of disinfectants — By injection — By drying — By embalming — 
Can contagious diseases be caught from corpses ? — The material for coffins 
— Cemeteries and their locations — Poisonous exhalations from cemeteries 
— Burning the dead. 




HE mortal remains of our departed friends 
demand our cares as the last and sorrowing 
tributes to the qualities for which we have loved and 
admired them. The duty is one we owe ourselves as 
well as them. And we should dispose of the dead in 
that manner most consonant to their wishes while in 
life, and consistent with the well-being of survivors. 

The customs of countries have singularly differed 
in this respect, and there is still a wide diversity of 
opinion among refined minds as to the disposition of 
the bodies of the departed. 

The rude Indians of the interior of Brazil lay hold 
of the corpse the moment life has departed, and hurry 
with it to the nearest stream, into whose sluggish 
current they toss it, and return home. All reference 

( 330 ) 



MODES OF SEPULCHRE. 331 

to the deceased is forbidden and even his name not 
mentioned. 

On the other hand, the Chinese preserve the bodies 
of their deceased parents in their houses, regarding 
them as still associated with the soul, and as exerting 
a beneficent influence on the fortunes of the family. 

The natives of Hindostan either burn the bodies of 
their relatives, or throw them into the sacred waters 
of the Ganges, to become the food of crocodiles and 
foul birds; while the Egyptians preserved with 
elaborate and extraordinary skill the bodies even of 
the lower animals. 

"Without discussing further the immense variety of 
modes of sepulchre which have prevailed, we shall 
give our attention to a number of practical points in 
reference to burials, cemeteries, and the disposal of 
remains as usual in this country. 

And first as to 



THE CARE OF THE CORPSE. 

"When the last breath has left the body, it becomes 
the duty of the attendant to compose the features of 
the corpse, and to lay it in a calm and decent position 
of repose. The eyes should be closed by bringing 
down the upper lids and holding them down for a 
minute or two. The lower jaw, which usually drops, 
should be closed and held in place by a bandage pass- 
ing around the chin and crown of the head. The 
limbs should be straightened, and the corpse laid on 
the back, the head somewhat elevated. 



332 THE DISPOSAL OP THE DEAD. 

Frequently discharges of froth or of a bloody fluid 
pass from the mouth or nose at the moment of death. 
These stains should be wiped away, and, if necessary, 
the apertures can be plugged with cotton. 

The special duties of the undertaker we need not 
here detail. Suffice it to say that the body should be 
thoroughly washed, the animal heat allowed to pass 
away on a " cooling board," and the burial garments 
be neatly adjusted. In case of adult males, the face 
should be shaven about ten or twelve hours after death. 

A curious belief exists among many that the beard 
and the nails continue to grow for a day or two after 
death. This notion, which seems supported by facts, 
rests on a misapprehension. The flesh contracts 
around and from the hairs of the beard and the nails, 
and they thus become more prominent, but it is not 
an actual growth. For this reason the shaving should 
be deferred for several hours. 



THE RIGIDITY OF DEATH. 

The corpse is said to " lie stiff in death." The mus- 
cles are rigid, the expression fixed, the joints immova- 
ble. The cause of this condition is not yet fully 
understood even by scientific men. 

It usually begins from six to eighteen hours after 
death, and lasts from twenty-four to thirty-six hours, 
when it gradually disappears. It varies, however, 
very materially, both in the rapidity of its onset and 
the length of its duration ; nor is it precisely known 
on what these differences depend. 



THE RIGIDITY OF DEATH. 333 

Army surgeons have noticed that soldiers instanta- 
neously killed on the battle-field often become stiff 
instantly, their features retaining perfectly the mental 
expressions on their faces when struck by the shot, and 
even their postures being preserved. In the recent 
Franco-German war, a Frenchman was found on the 
battle-field of Sedan, twenty-four hours after death, 
who had been killed by a grenade. A cup was still 
held delicately between the thumb and finger of one 
hand so as just to touch the lower lip, while the entire 
skull and face except the lower jaw had been carried 
away by the grenade. A German was found with the 
photograph of his wife or sweetheart raised in his 
hand so that he might take a last look at the moment 
that a fatal ball destroyed his life. 

On the other hand, it is asserted by some physicians 
that this rigidity does not occur at all in many cases 
of death-stroke of lightning; and also when persons 
die from excess of strong emotions. 

Forcible extension will destroy the rigidity. But 
if the extension is used before it is complete, the mus- 
cle may again become rigid. 

As a rule, as the natural warmth passes away from 
the body, the rigidity sets in; and as the rigidity 
gradually disappears, the signs of decomposition show 
themselves. 



HOW LONG- A BODY SHOULD BE KEPT. 

The question is often asked how long a body can be 
kept before it becomes offensive. 



334 THE DISPOSAL OF THE DEAD. 

The answer of course varies with the season of the 
year, the disease which proved fatal, and the weather. 
Cold weather, chronic diseases, and a dry air are favor- 
able for the preservation of the remains ; while heat, 
moisture, and rapidly fatal maladies all hasten the 
change of decomposition. Generally one or two days in 
summer, and three or four days in winter, are as long 
as a corpse should be kept, unless special means of 
preventing putrefaction are employed. 

The necessity of retaining the remains unburied for 
much longer periods than this constantly arises, either 
for the sake of transporting them home, or sending for 
relatives, or preparing for the funeral ceremonies. 
Hence, an important branch of our subject is to 
discuss the most convenient, cheap, and effective 
means of preserving bodies. 

HOW TO PRESERVE A BODY. 

The methods which have been adopted at various 
times for the preservation of corpses are very various. 
Some aim at temporary purposes merely, wiiile in 
others the ambition of the embalmer is extended to 
guaranteeing conservation beyond the utmost term of 
time, and to the "crack of doom" itself. 

The simplest means is 

BY COLD. 

The ice-box is very generally used in this country 
for arresting change for some days. It answers its 



TO PRESERVE THE BODY. 335 

purpose very well for about a week, but beyond that 
time is not a satisfactory expedient. 

Could continued cold of a severe degree — below 
zero, for example — be constantly applied, the body 
would remain stiff as a statue and perfectly free from 
change of any kind for an indefinite period. 

Strange examples of this are on record. Many years 
ago six Dutch sailors were left on the arctic island of 
Spitzbergen, to pass the winter there. As early as 
the ice-fields broke the following summer, a ship 
visited the island to inquire of their fate. They found 
them all dead, each remaining in the position in which 
he died, stark and frozen. One still held a pen and a 
note-book in his band, and had recorded that he was 
the last of the six, and felt that he was about to 
follow their fate. Nearly three months had elapsed 
since his hand had written those words and then had 
been overcome by the dreadful cold. 

The story of the ship discovered drifting in the 
Arctic Sea, with every soul frozen to death on board, 
yet remaining in the postures of their customary 
duties, although not veracious, expresses what might 
very possibly occur. 

BY THE EXTERNAL USE OF DISINFECTANTS. 

A more convenient and cheaper method is to use 
externally some powerful disinfectants. Of these, we 
recommend two, as having been thoroughly tested, 
and capable of preserving the remains, under ordinary 
circumstances, for several weeks. 



336 THE DISPOSAL OF THE DEAD. 

The first is sulphate of zinc. One part of this sub- 
stance is to be mingled with two parts qf sawdust, 
and a thin layer placed over the whole body. 

The second is carbolic acid. Clothes can be wrung 
out in this and the body wrapped in them, or sawdust 
moistened with the acid can be sprinkled over it in a 
thin layer. In either case, the whole surface must be 
thoroughly protected. 



BY INJECTION". 

During the late war, the bodies of the fallen on the 
battle-field, which were sent home, were usually pre- 
served by injecting into the bloodvessels a solution of 
a powerful disinfectant. By this means they could 
be kept for two months without material change. 
The same plan is that generally adopted to preserve 
those used in dissecting-rooms. A solution of the 
"arseniate of soda," or of the chloride of zinc, is that 
generally used. 

Inasmuch as to carry out this method successfully 
demands anatomical knowledge and considerable ex- 
pertness, we need not enter into particulars. 

BY DRYINGL 

It is astonishing how much of our bodies consists of 
water. And this amount of water it is which more 
than any other element hastens its decay. 

The grave-digger in Shakspeare's play of Hamlet 
had learned this fact. He asserted that a tanner's body 



TO PRESERVE THE BODY. 337 

would last nine years ; and when Hamlet asks, "Why 
he more than another?" the grim joker replies : "Why, 
sir, his hide is so tanned with his trade that he will 
keep out water a great while ; and your water is a sore 
decayer of your dead body." 

Several nations have preserved their dead by drying 
the bodies very slowly so as to extract all the mois- 
ture. The ancient inhabitants of the island of Tene- 
riffe had this custom, and Alexander von Humboldt, 
who obtained several of these desiccated remains, 
states that the body of an adult male, thoroughly 
dried, weighed only eight or nine pounds ! 

Some monasteries in the Levant continue this 
strange procedure. When one of the monks dies, they 
take his corpse, and, having thoroughly desiccated it, 
dress it in the usual robes of the order, and place it 
in a niche in the cellar. Long rows of the deceased 
members of the order can there be seen, forming a 
startling and curious spectacle. 

BY EMBALMING. 

The earliest account that we have of this art is 
found in the last chapter of Genesis, where we are 
told that Joseph commanded his servants and physi- 
cians to embalm his father. From the manner in 
which it is recorded, it was evidently a usual occur- 
rence, in operation every day. In the 26th verse of 
the same chapter, Joseph's death and manner of 
burial are recorded ; he was embalmed and put in a 
coffin in Egypt. 

22 



338 THE DISPOSAL OF THE DEAD. 

In Chronicles it is also mentioned that Asa's body 
was laid in a bed filled with sweet odors and divers 
kinds of spices prepared by the apothecaries' art. 
Also, in the New Testament there are passages 
showing that it was considered an imperative duty 
to embalm the dead ; for, when the woman was re- 
buked for pouring the ointment of spikenard on the 
Saviour's head, he said : " Let her alone ; she hath 
wrought a good work on me ; she hath done what she 
could ; she hath come aforehand to anoint my body to 
the burying." Nicodemus is said to have brought a 
hundred pounds of aloes and myrrh to embalm the 
body of Jesus. The quantity has been exclaimed 
against by certain Jews, as being enough for fifty 
bodies ; but Josephus tells us that at the funeral of 
Herod there were five hundred spice bearers, and at 
that of Gamaliel, eighty pounds of spice were used. 

Dogs, cats, wolves, birds, and crocodiles appear to 
have been subjected to the same process in Egypt, to 
preserve them ; at all events, they are found in vast 
numbers in an admirable state of preservation. 

We must bear in mind that it never rains in that 
region. There is neither record nor tradition that it 
ever rained even as low down the river as the present 
city of Cairo. Occasionally there are slight showers 
at Alexandria, which is on the border of the Mediter- 
ranean ; and at Cairo there is sometimes a foggy 
condition of the atmosphere, slightly damp, but 
nothing more. 

Although the Bedouin Arabs have been pillaging 
the mummy pits for more than six hundred years, for 



PRECAUTIONS AT FUNERALS. 339 

rings, sandals, caps, jewelry, sarcophagi, and curious 
marks of ancient art, which they are constantly 
bringing to light, there are still mummies enough 
remaining to give them employment, in the same 
manner, for a thousand years to come. It is said by 
those who have been in Egypt since the cars com- 
menced running on the newly constructed railroad, 
that mummies have been actually used as fuel for the 
locomotives ; but we hope this is an error. 

The process used by the Egyptians is tolerably accu- 
rately known, but is of comparatively little interest at 
the present day. The climate more than the spices 
preserved the relics of the ancient dwellers by the Nile. 

CAN CONTAGIOUS DISEASES BE CAUGHT FROM CORPSES? 

"When asked to a funeral in this country, it is cus- 
tomary to enter the room where the corpse is laid out, 
and approach it in order to take a last look at" the 
mortal features of a departed friend. 

As so many diseases are communicated directly 
from one person to another, it becomes of great moment 
to decide whether the poison of a contagious disease 
can be disseminated by the corpse of one who has suc- 
cumbed to it. The answer to this question is not 
unanimously given. But, without entering into argu- 
ments, we must express our firm and full conviction 
that contagious diseases can be, and frequently are, 
disseminated by corpses, and especially by the habit 
at funerals which we have just adverted to. "We 
believe the custom should be dispensed with whenever 



340 THE DISPOSAL OF THE DEAD. 

the disease is communicable; and no secrecy on this 
point should be attempted to be maintained. 

Persons should insert in the funeral notice the cause 
of death; and it is imprudent for any one to attend a 
funeral when he is ignorant of the malady of which 
the deceased has died. 

Bodies of those dying of contagious disease should 
not be transported on public thoroughfares. And in 
every respect the greatest precautions should be 
observed that the dead do not contaminate the living. 

For this reason, as well as others, we unqualifiedly 
condemn funeral feasts, and " wakes." These are now- 
adays rarely the scenes of festivity, maudlin grief, and 
actual drunkenness which they frequently were a 
generation ago. But any necessity at all of "funeral 
baked meats," or still less of alcoholic drinks, does not 
now exist, except in remote country localities. 

They contribute in a marked manner to spread 
disease. As late as the current year (1871), the mayor 
of Belfast, Ireland, has had occasion to remonstrate 
with the inhabitants of that city, and to point out to 
them that the ravages of the smallpox had been vastly 
increased by the custom of friends and neighbors 
assembling at the funeral of those who had died of 
that disease. 

An English physician reports that at the last 
visitation of the cholera a woman died of the disease 
in a populous district of London. Her husband invited 
a large number of persons to her wake, and distributed 
freely intoxicating drinks. The consequence was that 
in a few weeks nearly one hundred and fifty cases of 




To face p. 341 



The Country Churchyard and the City Cemetery. 



RESTING-PLACES FOR THE DEAD. 341 

cholera occurred among the participants in the affair, 
many of them fatal. 

THE MATERIAL FOR COFFINS. 

The usual material of which coffins are constructed 
is wood, and probably it is superior to anything else. 
Leaden coffins were in former years quite popular 
among the wealthy classes, but they are open to the 
objection that, being air-tight, the gases which are 
generated during the decay of the body occasionally 
exert enough force to cause an explosion, and burst 
open the sides with a noise said to be equal to that of 
a small piece of artillery! 

Such incidents have doubtless been the occasional 
source of some of the ghastly stories which are con- 
nected with disturbing the remains 6f the dead. 

The metallic caskets now manufactured with great 
elegance guard against similar accidents by providing 
for the escape of the gases. 

CEMETERIES AND THEIR LOCATION. 

The word "Cemetery" is of Greek origin, and 
means a "resting" or "sleeping place." And so it is 
in fact the spot where sooner or later we must all be 
taken and consigned to the eternal sleeps and undis- 
turbed rest of Death. Happy we, if we can go 

"As one 
Who folds the drapery of his couch about him, 
And lies down to pleasant dreams." 



342 THE DISPOSAL OF THE DEAD. 

But still more beautiful than this word of foreign 
lineage is that term which our own ancestors used to 
apply to the burial-ground — " God's acre" or field. 
As our American poet, Longfellow, has so nobly 
sung : — 

"I like that ancient Saxon phrase, which calls 
The burial-ground God's acre ! It is just : 
It consecrates each grave within its walls, 
And breathes a blessing o'er the sleeping dust. 

"Into its furrows shall we all be cast, 

In the sure faith that we shall rise again 
At the great harvest, when the archangel's blast 
Shall winnow, like a fan, the chaff and grain. 

u Then shall the good stand in immortal bloom 
In the fair gardens of that second birth ; 
And each bright blossom mingle its perfume, 
With that of flowers which never bloomed on earth." 

% 

These glorious associations, which to the Christian 
rob the grave of its terror and dispel the gloomy hope- 
lessness which to the heathen and the infidel enshroud 
the future, should lead him to surround the burial- 
places of the dead with pleasant sights and beautiful 
works of art. A graveyard should attract him rather 
than repel, and it should be so situated and governed 
by wise regulations as to render it an agreeable and 
desirable spot. 

This can never he if cemeteries are located in cities. 
The churchyards of cities are foul pest holes, planted 
with bodies over and over again, breeding poisonous 
emanations, sickening thousands, and condemned by 
every law of decency and health. The descriptions of 
the London churchyards, before it was forbidden to 



PROPER SITE FOR A CEMETERY. 343 

inter any more in them, are the most horrible and 
revolting revelations on the pages of sanitary history. 

The energy with which a few devoted men assailed 
the plan of "intra-mural interment," or interment 
within cities, is most deserving of praise, and the 
services they have rendered are most meritorious. !No 
village and no town should have a burial-place within 
its inhabited precincts. 

A site for a cemetery should be chosen from half a 
mile to a mile distant from the town, capable of being 
improved in accordance with the laws of landscape 
gardening. The drainage should be sufficient to 
carry off both the surface and the subsoil water. 
The soil itself should be, by preference, a light 
gravelly loam, or clay to the depth of ten feet. The 
earth, when clayey (aluminous), is an excellent disin- 
fectant, and the dryer the soil the more slowly will the 
changes of decomposition take place. 



POISONOUS EXHALATIONS PROM CEMETERIES. 

The gases which exhale from decaying bodies are 
poisonous, and in repeated instances have brought 
about disastrous results on those exposed to them. 
This was often the case when, as in old times, bodies 
were deposited in vaults beneath the floors of churches. 

In one instance in the last century in France, there 
was a company of one hundred and twenty people 
assembled in a church at a time an old vault was 
opened. The stench was nauseous and unbearable, 
and many were sickened by it at once. They all 



344 THE DISPOSAL OF THE DEAD. 

hastened from the church, but only six of the one 
hundred and twenty escaped severe illness, and many 
of them died, among the number the curate and the 
vicar of the parish. 

The alleged immunity of grave-diggers is no 
refutation of the poisonous character of these gases. 
This class of workmen are rarely robust and rarely 
long-lived. Moreover, as in countless other examples, 
the system, through long custom, has become habitu- 
ated to these vapors, and can withstand them better 
than those unaccustomed to them. 

It is, therefore, essential to the healthfulness of a 
cemetery that these vapors be neutralized. This can 
be done by adopting several precautions. 

In the first place, the bodies should be buried at a 
considerable depth, say eight or ten feet, in a clayey 
soil which is dry and well drained. Second, burials in 
the same grave should be positively prohibited, and 
no part of the ground should be used twice, no matter 
how much time has intervened since the earlier burials. 
Broad walks and drives with subsoil drainage should 
be laid out between the lots. 

Experience has proven that an abundance of vege- 
table life absorbs and neutralizes the exhalations of 
graveyards. They should be thickly planted, there- 
fore, with trees and shrubs, and the open spots well 
set with varieties of rich grass. Deciduous trees of 
rapid growth are to be preferred to the slow-growing 
evergreens, hollies, and cypresses so generally seen. 
Moreover, there is no need to make a cemetery 
gloomy. Such an aspect is inconsistent with a firm 



THE FUNERAL PILE. 345 

faith in an after-life ; it is a relic of darker ages, when 
the gospel preached was, "Eat, drink, and be merry, 
for to-morrow ye die." 

The country churchyards and the cemeteries of 
cities should be maintained in perfect order, and all 
should emulate to show a similar solicitude about 
these cities of the dead to that which has given such 
renown for beauty to those famous grounds, Mount 
Auburn, Greenwood, and Laurel Hill. 

BURNING THE DEAD. 

During the bloody battles between the French and 
German forces in the war of 1870, so many thousands 
fell, that the capacity of the sanitary corps was over- 
tasked, and it was impossible to bury the dead. Some 
surgeons, therefore, proposed to burn the bodies, and 
the project was successfully carried out. 

The ancient Romans were wont to dispose of their 
dead in this manner. The corpse was placed upon a 
funeral pile and consumed; the ashes were carefully 
collected and placed in a vase, which was sealed and 
preserved with religious solicitude. 

In like manner the Scandinavians of a later day 
treated the bodies of their Vikings. The sea-rover 
was placed in his boat, and wood piled over it. A 
torch was applied, and the ashes of the pile scattered 
on the waters or covered with a mound of earth. 

To many minds such a disposition of the body is 
far more agreeable to contemplate than to have it 
consigned to the damp earth, and pass through the 



346 THE DISPOSAL OF THE DEAD. 

loathsome stages of decomposition. The poet Shelley 
left an earnest request that his corpse should be 
burned. This injunction was carried out under the 
supervision of his friends Lord Byron and Mr. Tre- 
lawney, and the latter has left a minute and very 
disagreeable narrative of the method adopted. 

It requires an intense and prolonged heat to con- 
sume a body, and it is not easily done by a wood fire. 
Possibly this ancient custom, which certainly has 
many sanitary arguments in its favor, may come 
again into general adoption. But at present the 
suggestion would probably not meet with a favorable 
reception. 

The tendency of the public mind at present is rather 
to seek some chemical means of easy application to 
preserve the remains from decay. Doubtless chemistry 
will easily respond to such interrogations, but of what 
avail is it to save this wretched body when the spirit 
has departed ? "Wiser than these, the grim old philoso- 
pher Diogenes, when asked what should be done with 
his body after death, replied, " Cast it into the gutter." 
""Why," exclaimed his shocked friends, "the dogs 
will devour it." " Then put a stick in its hands, to 
drive them away." "But it cannot use a stick." " If 
it cannot do that," was the triumphant rejoinder of 
the sage, "I care not for it." 

The Christian, however, needs not the refuge of a 
brutal stoicism. He has learned that the future of the 
soul, not of the body, is that which concerns him ; and 
exclaims, with one of England's gifted bards : — 



THE FUTURE OF THE SOUL. 347 

44 Why should this worthless tenement endure 

If its undying guest be lost forever ? 
Oh let us keep the soul embalmed and pure 

In living virtue, that, "when both must sever, 
Although corruption may our frame consume, 
The immortal spirit in the skies may bloom." 




PART II. 



THE NURSING OF THE SICK, 



INTRODUCTORY. 

THE IMPORTANCE AND DIVISIONS OF THE SUBJECT. 

Nursing a matter of national concern — The knowledge needed by a nurse — 
The divisions of the subject. 



ITHERTO we have occupied the attention of 
our reader with those principles of hygiene 
the knowledge and the application of which are best 
calculated to preserve health and secure long life. 
We now come to the second part of our work, in which 
we will endeavor to make plain the principles of nurs- 
ing — the art of properly caring for the sick. 



THE SUBJECT OF NATIONAL INTEREST. 

The importance of our theme we feel we cannot over- 
rate. In the language of the distinguished Professor 
of Surgery in the Jefferson Medical College, Dr. 
Gross — 

"The subject of nursing possesses a deep national 

(349) 



350 INTRODUCTION. 

interest. It personally concerns every human being, 
of whatever age, rank, or condition in life — alike the 
rich man in his palatial residence, the mechanic in his 
cottage, and the peasant in his humble hovel. All are 
alike intimately interested in its faithful administration 
and in its final issue. It is perhaps fortunate that the 
mortality occasioned by bad nursing cannot be properly 
estimated by those more immediately affected by it, as 
a knowledge of it would entail upon them an immeasu- 
rable amount of misery and mental anguish. Mankind 
look with horror upon the destruction of human life 
upon the battle-field and during the prevalence of epi- 
demics, as cholera, scarlet fever, and smallpox, because 
its appalling character is everywhere patent to the 
public eye; every one sees and hears and talks about 
it; but few persons can form any adequate conception 
of the vast number of human beings who are daily, 
nay, hourly, sacrificed upon the unhallowed altar under 
consideration." 



THE KNOWLEDGE REQUIRED FOR GOOD NURSING. 

After pointing out the peculiar fitness of women 
for the vocation of nursing, Prof. Gross enumerates 
among the qualifications of a good nurse the following 
educational necessities : — 

1. A knowledge of the principles of hygiene, 
especially of ventilation, clean linen, temperature, and 
the nature and use of disinfectants. 



KNOWLEDGE NEEDED FOR NURSING. 351 

2. An acquaintance with the methods of preparing 
food and drink. 

3. Information in regard to the administration of 
medicines, and familiarity with the doses of the more 
common medicines employed in the treatment of 
disease. 

4. Instruction in the application of leeches, blisters, 
bandages, and other dressings, as poultices, ointments, 
and lotions. 

5. Training in the art of making up beds, changing 
sheets, and handling patients exhausted by disease 
and injury. 

This information it has been our purpose to place in 
the hands of every mother and daughter who peruses 
this book. The first requisite for good nursing, just 
named, "a knowledge of the principles of hygiene, 
especially of ventilation, clean linen, temperature, and 
the nature and use of disinfectants," has been dwelt 
upon at length in the first part of our treatise, now 
brought to a close. We shall endeavor, in this the 
second division of our work, to lay before the reader 
precise and reliable information in regard to the other 
requisites for good nursing above enumerated. 



THE DIVISIONS OF OUR SUBJECT. 

The subject of nursing we shall, for convenience of 
presentation and reference, divide as follows: First, 
The nursing of children; Second, Of adults; Third, 
Cookery for the sick; Fourth, The administration and 



352 



INTRODUCTION. 



external application of medicines ; Fifth, Accidents in 
the sick-room ; Sixth, Notes and matters on nursing ; 
Seventh, The care of the aged; Eighth, The care of 
the idiot and imbecile; Ninth, The care of the inebri- 
ate. We shall aim to group under these various heads 
those principal facts in regard to the care of the sick 
and feeble, which every woman should know. 




ifliPiiSPP 


^^^^^J^^J^^j^^ 



CHAPTEE I. 

THE NURSING OF CHILDREN. 

Section I. The Recognition op Disease in Children. Distinction 
between slight ailments and actual diseases — Signs of disease in child- 
hood : Position and movements ; Loss of flesh ; Expression of the face ; 
Dislike of light and noise ; Manner of crying ; Character of the cough ; 
Changes in the pulse ; Nature and seat of pain ; Heat of skin ; Disturbed 
sleep ; Appearance of the tongue ; Manner of drinking ; The appetite ; The 
belly ; Vomiting ; The passages ; Convulsions. 

Section II. The Chamber op the Sick Child. Order and cleanliness 
— Ventilation — Quietness — Amount of light — Temperature — Visitors. 

Section III. The Person op the Sick Child. CI eanliness— Bathing : 
How to bathe a sick child ; Cold, warm, hot, and medicated baths — The 
linen — Bed and bedding. 

Section IV. The Food and Drinks op the Sick Child. The amount 
of the drinks — The temperature of the drinks — Diet drinks : Barley-water; 
Oatmeal gruel ; Rice-water ; Toast-water ; Sour drinks ; Milk ; Tea ; 
Coffee — Dietetic preparations : Arrowroot pap ; Arrowroot pap with 
milk ; Tapioca ; Sago ; Panada ; Pap of unbolted flour ; Pap of boiled 
flour ; Gelatine food ; Dr. Merei's food for children ; Arrowroot and beef- 
tea ; Prof. Liebig's soup ; Raw meat ; Prof. Trousseau's receipt — Atten- 
tion to giving food — Quantity of food and number of meals. 

Section V. The Recovery op the Sick Child. Neglect of the conva- 
lescent — Period of confinement to the bed and room — Diet of the conva- 
lescent — Exercise during convalescence — When to return to school. 




O learn how to properly care for her child when 
sick, should be an object dear to the heart of 
every mother. It is not enough that she should seek 
for her little one when stricken by disease the best 

( 353 ) 



23 



354 THE NURSING OF CHILDREN. 

medical skill within her reach. The physician can 
only fight half the battle ; if he be unaided by good 
nursing, or thwarted by badly-directed though well- 
intentioned efforts, in vain will be his wisest counsels, 
his best skill. Many a child has died who might have 
been saved, had the mother been able intelligently to 
second the efforts of the physician. Many a child 
will be saved in the future if mothers can be awak- 
ened to the importance of our present theme, and 
induced to lay up as a precious treasure that know- 
ledge upon which, as upon a last thread, may some 
day hang the very lives of those nearest and dearest 
to them. 

I. The Kecognition of Disease in Children. 

This is not always an easy task, as numerous anx- 
ious mothers causelessly alarmed, numerous wearied 
physicians unnecessarily called from their needed rest, 
and numberless deaths occasioned by the want of a 
timely recognition of the existence of disease, will 
testify. We shall endeavor to point out some of the 
most prominent signs of disease, which every mother 
is capable of recognizing. In the first place, we must 
try to draw the line of 



distinction between slight ailments and 
actual diseases. 

This distinction is, doubtless, often a difficult and 
delicate one. Still, we do not deem it beyond the 



TO DISTINGUISH INDISPOSITION" FROM SICKNESS. 355 

powers of a w^ell-informed and observant mother. If 
she have any doubt as to the correctness of her 
opinion, she should call in the family physician, in 
order that the child may have that early medical care 
so important at the outset of a serious malady. There 
are certain signs and symptoms, easily noticed, which 
may enable the parent to tell a trifling indisposition 
from a threatened illness. Among these we shall 
mention — 

1. THE RAPIDITY OF THE ATTACK. 

The slight disorders of the health, to which all 
children are liable, have no precursory symptoms, nor 
any slow convalescence — simple disturbances of the 
system, due to passing impressions, they quickly come 
and go. Serious diseases, on the contrary, are pre- 
ceded by several days of depression and languor; the 
child is unwilling to play, it becomes fretful and irri- 
table, it seeks of its own accord to lie down, its appe- 
tite is disordered, it sleeps badly, the face is more or 
less dejected, the skin is pale, the eyes are encircled 
with dark borders, and there is some loss of flesh. 
When these signs exist, all or many of them, and they 
persist, there is reason to fear the invasion of a serious 
disease. 

2. LOSS OF FLESH. 

Children lose and gain flesh with great rapidity, 
"With them roundness of limb and fulness of face have 
an important signification. The careful mother will 



356 THE NURSING OF CHILDREN. 

not content herself with the merely superficial assur- 
ance of the good condition of her child furnished by 
the eye; she will consult the scales. A child ought 
to be weighed at least once a month, and oftener when 
the health appears to be threatened. A well-nourished 
child ought not only to keep up its weight, but to 
increase it; when the contrary is the case, it is an 
indication of a tendency to disease, which the physi- 
cian ought to investigate and remedy. Ordinarily a 
falling off in flesh with children shows either that 
some acute affection is about to make its appearance, 
or that some chronic disease has already commenced 
to fasten itself upon the constitution. 

3. CHANGE IN THE CHARACTER AND HABITS. 

The least changes in the disposition of a child are 
readily noticed, for that concealment of the feelings, * 
so common in adult life, is unknown in infancy 
and early childhood. Both slight indisposition and 
actual disease bring with them alterations in the 
temper and character; but the first shows itself by an 
exacting and irritable humor, the latter by indifference 
and torpitude. This statement may not be without 
exception, but it is very general. A child merely 
indisposed is ill-tempered and troublesome, a child 
really sick is dejected and apathetic. Hence, mothers 
with good reason gladly notice when their sick 
children become exacting and tormenting — it is an 
undoubted sign of returning health. The child which 
is only out of S07*ts, frets itself because of its distemper ; 



TO DISTINGUISH INDISPOSITION FROM SICKNESS. 357 

it wishes to pursue its ordinary life, to play, to run, to 
eat as usual, but is unable to do so with comfort. It 
revolts, therefore, against itself, cries without cause, 
calls for and rejects the same object, and passes from 
one extreme to the other. The siclc child, on the con- 
trary, is more astonished, as it were, than irritated; it 
desires repose rather than caresses, its little face is 
neither lighted with a smile nor darkened by a frown, 
it has an air full of care, as if filled with the presenti- 
ment of coming suffering. Gayety is the natural con- 
dition of childhood. Transient ill -health hides for a 
moment, but does not entirely do away with, this 
natural cheerfulness, which breaks forth now and then 
in the smile which follows the tear. Any evidence of 
playfulness is reassuring, its entire absence ought to 
inspire legitimate anxiety. A sad child is a mournful 
abnormality. This sadness is more serious if its 
chagrin and cries are unaccompanied by tears. A 
dry eye, a grave disease, is an aphorism, the justice of 
which is rarely at fault. 

4. IDLENESS AND LISTLESSNESS. 

Active motion is a physiological need with the child. 
In health we find it in a state of constant activity, 
never resting for a moment while awake. There is, 
then, a cause for anxiety when it seems listless and 
indisposed to exertion, seeking repose rather than 
action. This alarming tranquillity is the more men- 
acing in proportion as the child may be naturally lively 
and active, filling the house with its endless and tur- 



358 THE NURSING OF CHILDREN. 

bulent gayety. This unusual apathy is, above all, a 
serious sign of some approaching disorder of the brain. 
When a child, however well it may look, manifests a 
distaste for running about and playing, when it will- 
ingly remains for entire hours seated in its little chair, 
watching with indifference the sports of its playmates, 
it is menaced with an illness near at hand. 

Fever, cough, vomiting, and diarrhoea are present in 
both slight and serious ailments. Their characters are 
different, however; we shall therefore consider them in 
detail presently. 

In any observant family, by the aid of the distinctions 
we have just laid down, it will be ordinarily easy to 
tell those disorders which need merely home care from 
those which call imperiously for the skilled practi- 
tioner of the art of healing. Summon, therefore, with- 
out delay the family physician when the signs we have 
mentioned justify alarm, and thus put the responsibility 
of treatment in its proper place. When, however, 
the trouble is evidently only a passing indisposition, 
quiet, an even, properly regulated temperature, and 
attention to the diet, will usually restore the health. 
Let every mother bear in mind that many a serious 
illness has had its origin in a slight disorder which has 
been neglected. An enforced rest, a protection from 
exposure, and a restricted, selected diet would at first 
have been all that was necessary: the omission of 
these cares, so readily attended to, has compromised all, 
and the doctor has been obliged to intervene, when it 
was so easy to have prevented the necessity for calling 
him in. 



SIGNS OF DISEASE IN CHILDHOOD. 359 

We will now pass to the consideration, with some 
minuteness, of 

THE SIGNS OF DISEASE IN CHILDHOOD. 

These signs vary of course, both with the age of 
the child and with the nature of the malady. We 
shall first dwell upon the meaning of the various 
symptoms which show themselves in children, and 
then note the special signs which indicate disease of 
the brain, lungs, stomach, etc. 

First in regard to 

THE POSITION AND MOVEMENTS OF A SICK CHILD. 

The attitude and gestures of the child, particularly 
the position it takes when it lies down, afford useful 
information as to the nature and extent of the malady. 
Healthy children will fall asleep in any posture, and 
rest quietly and uninterruptedly in that manner, 
ordinarily upon the side, but frequently upon the 
back. How changed is the sick child in this respect. 
So far from resting quietly, the little one tosses about 
impatiently. The sleep is no longer sound and com- 
fortable, but is agitated and broken by starts and 
cries. 

The nature of the gestures deserves attention. Sud- 
den twitches and starts denote attacks of sharp pain 
such as occur in colic, shooting headache, and stitches 
in the side. The drawing up and throwing down of 
the legs, with cries, are usually evidences of the 



360 THE NURSING OF CHILDREN. 

suffering produced by wind in the bowels, and cease 
so soon as the wind is passed off. The movements of 
the hands will often show the seat of pain. In head- 
ache or earache the hand is constantly being carried to 
the head or ear. The pain caused by teething leads 
to the putting of the hands into the mouth ; when 
there is irritation about the brain, they are apt to pull 
at the hair; in case of worms, they bore and pick 
at the nose or fundament; in croup, they rub the 
neck; and, in attacks of colic, older children press 
with both hands upon the belly. The occasional roll- 
ing of the head from side to side, although present in 
certain diseases of the brain, does not necessarily 
denote any serious trouble, and ought not, therefore, 
to excite undue alarm. 

Extreme restlessness, a constant desire to pass from 
the arms to the bed and from the bed to the arms, 
or incessant tossing about from side to side of the 
bed, is an unfavorable sign in many grave affections. 

The position which the child prefers and assumes 
furnishes a guide to the nature of the disease. In 
catarrh of the chest and inflammation of the lungs, 
the child wishes to be propped up high in the bed, to 
an almost sitting posture, or to be supported, when 
very young, in the arms of the nurse, with the head 
and shoulders raised. If placed flat down in the bed, 
cradle, or lap, it will show signs of uneasiness and 
discomfort. In these cases, the infant will often 
prefer to be held in the arms, with its head hanging 
over the shoulder of the nurse. In inflammation of 
one lung, the child will desire to lie upon the back or 



SIGNS OF DISEASE IN CHILDHOOD. 361 

upon the affected side, and will at once turn over if it 
be laid upon the unaffected side. In many diseases 
of the bowels, the inferior extremities are drawn up, 
the legs being bent upon the thighs, the knees raised 
towards the chest, and the child showing great un- 
willingness to straighten out its limbs. In cases of 
scrofulous inflammation of the eyes, the child will be 
found to lie upon its face ; and will often take the 
same position when suffering from some forms of 
headache. Children wasting away from defect of 
nourishment will frequently be noticed to keep their 
thumbs drawn inwards and their hands firmly closed. 
Naturally, in early life, a healthy child sleeps with its 
arms somewhat raised, its hands lying upon the chest 
and approaching the chin. In the exhaustion pro- 
duced by debilitating diseases, such as diarrhoea, the 
arms will be found resting by the side, while, on the 
contrary, in certain brain diseases the hands are ex- 
tended over the head or thrown against the forehead. 



LOSS OF FLESH. 

This is the next sign of disease in childhood, which 
we will consider. The rapidity with which emacia- 
tion takes place varies with the disease. In acute, 
severe affections, the loss of flesh is very rapid; in 
slow, long-standing maladies, it is gradual, but is 
oftener carried on to a greater extent, so as to reduce 
the child's body and limbs to little more than a frame- 
work of bone with a loose covering of skin. The 
inner surfaces of the thighs are the best places in which 



362 THE NURSING OF CHILDREN. 

to seek for the earliest signs of emaciation. A short 
illness, a diarrhoea of only a few hours' duration, will 
render these naturally firm, tense surfaces relaxed and 
soft. When the disease is at all advanced, flabby 
folds displace here the former symmetrical roundness 
of the parts. So soon as convalescence begins, return- 
ing fleshiness is also first shown on the inner surfaces 
of the thighs, which recover their shape and solidity 
with surprising quickness. 

EXPRESSION OF THE FACE. 

In very young children, the change of expression 
which takes place in the countenance, under the influ- 
ence of disease, is marked, and often affords valuable 
aid in distinguishing the nature of the affection. In 
profuse diarrhoea, for instance, and particularly in 
cholera, the face of an infant will change so much 
that, in the short space of twenty-four hours after the 
attack, it can scarcely be recognized. 

At the outset of illness, the countenance becomes 
dull and heavy ; it no longer lights up on the approach 
of mother, father, or playmate. Flushing of the face 
is also an early accompaniment of some affections. 
If any of these changes in the appearance of the 
child are persistent, and attended with disordered 
bowels and disturbed sleep, they call for immediate 
medical attention, for fear a serious ailment may ob- 
tain too strong a foothold. 

Every disease, to some extent, gives to the face its 
own peculiar expression, and, by the part of the face 



SIGNS OF DISEASE IN CHILDHOOD. 363 

chiefly altered, the experienced eye may distinguish, 
to a great degree, the organs diseased. Thus changes 
in the upper part of the face, the forehead, and eyes, 
denote affections of the brain; in the middle of the 
face, particularly the nostrils, affections of the chest; 
in the lower part of the face, the mouth, and lips, 
affections of the bowels and abdomen. It is often 
difficult, however, for a physician to tell the exact 
disease by a mere inspection of the face. But there 
is one sign readily noticed, which points with great 
certainty to inflammatory diseases of the lungs, 
namely, the increased movements of the sides of the 
nostrils, their rapid rising with each breath. 

There is no mother who is not familiar with the heavy 
look about the eyes to which we have already referred 
as a precursor of sickness. Upon observing it, she is 
accustomed to say the child does not "look well." 
The manner in which the eyelids are raised furnishes a 
valuable indication of weakness. The appearance of 
crossing of the eyes is an evidence of approaching 
brain disease. Of course, this remark does not apply 
to cases in which squinting has always existed, nor to 
those instances in which it is acquired by the imitation 
of those who have this deformity. The half-opened 
eye during sleep, which so often alarms the mother, 
is not necessarily denotative of any trouble. Most 
nurses will attribute it at once to worms. It is fre- 
quently seen when there are no worms present. An 
overloaded stomach, or wind in the bowels, will occa- 
sion it. It is often merely an indication that the child 
is not soundly asleep, but only drowsy. The rolling 



364: THE NURSING OF CHILDREN. 

up of the eyes, which can then be seen, is natural, it 
always takes place during sleep, but the fact is usually 
hidden by the completely closed lids. 

From the expression of the lips and mouth much in- 
formation may be gathered. Thus, when the lips are 
slightly parted and pale, and the mouth surrounded 
with a white circle, the child is sick at the stomach and 
probably about to vomit. When, however, the lips are 
compressed, and the nose pinched and sharp, while the 
mouth is surrounded by this white circle, then we may 
know the child is suffering pain. 

Pain is always indicated by the countenance, but 
the exact seat of the pain cannot always be told from 
the features. It has been said that pain in the head 
occasions contraction of the eyebrows; pain in the 
chest, sharpness of the nostrils; and pain in the bowels, 
an elevation of the upper lip. But pain anywhere is 
very apt to distort the whole face, and it is only by 
taking into account other signs that we are able to 
locate the site of the suffering. 

CHANGES IN THE COLOR OF THE FACE 

Are interesting and instructive. Fevers are ushered 
in with a face suffused and deeply red. "When the 
attack is very severe and sudden, the face may be paler 
than usual. Great whiteness and glossiness of the 
skin in the latter stages of inflammatory diseases of 
the lungs and throat, is an unfavorable sign. In dis- 
orders of the digestive organs, the face assumes a 
sallow hue; in affections of the liver, it becomes yellow; 



SIGNS OF DISEASE IN CHILDHOOD. 365 

in long-standing disease, it takes a waxy pallor which 
is very striking; in some diseases of the lungs and 
heart, it appears bluish or livid. The intense blueness, 
not only of the face, but of the whole surface, which is 
sometimes presented by an infant from birth — " a blue 
baby," as it is called — is owing to an imperfection of 
one of the valves of the heart, which permits of the 
mixture of the blue venous with the red arterial blood. 
Exhaustion is revealed by coolness and want of color 
in the face, and by a livid hue of the lips and eyelids. 

DISLIKE OF LIGHT AND NOISE. 

The mother or nurse ought carefully to watch for any 
signs of undue sensitiveness to light or noise on the part 
of the sick child, and, if any be noticed, report the fact 
to the attending physician. If a child be old enough, 
it will complain of the brightness of the room, or of 
the usual noises about the house. If too young to 
mention its annoyance, its manner of shutting the eyes 
and turning away from the light, or its painful starts 
on hearing the slamming of a door, or even a slighter 
noise, one which in health would not excite attention, 
will indicate the increased, sensibility of the senses of 
sight and hearing. 

One of the first evidences of the disease known as 
scrofulous ophthalmia, a peculiar inflammation of the 
eyes occurring in scrofulous children, is an excessive 
intolerance of light, the child running to its mother 
and hiding the head in her lap. "We need scarcely 
add that this conduct of a child should lead without 



366 THE NURSING OF CHILDREN". 

loss of time to an examination of the eyes by a com- 
petent physician. 



THE CRT OF THE SICK CHILD. 

The cry is the language of the child. By this 
means it expresses its wants and its sufferings. The 
cry varies greatly in character, and serves the experi- 
enced ear as an index to the nature and degree of the 
disease. 

The tone of the cry is peculiar to each child, like 
the tone of the adult voice. But the manner in which 
the cry is uttered, and its pitch, are influenced by 
circumstances ; and from this variation important con- 
clusions may be drawn. 

In inflammatory affections of the lungs, children never 
cry loudly nor continuously; but now and then, either 
after drawing a deeper breath than previously, or 
after a cough, they give a little half-suppressed cry, 
which they check before it is finished, because of the 
pain or want of breath it causes. The child is, there- 
fore, unusually quiet, and loth to cry, in diseases of 
the lungs. It emits only a low, painful moan, except- 
ing in pleurisy, when the cough, the moving of the 
child, or pressure on the inflamed side, will some- 
times excite an outburst of shrill, highly pitched 
crying. 

In stomachache, the cries of a young child are 
accompanied with twists and contortions of the body, 
and the cry itself is loud and passionate; it is not 
regular, but ceases for a few moments, and is then 



SIGNS OF DISEASE IN CHILDHOOD. 367 

resumed, the legs being drawn violently up to the 
stomach. As the pain passes off, the legs are relaxed 
and extended, and the child sobs itself to sleep. The 
fact that the crying precedes, attends, or follows a 
stool, also points to its being occasioned by some pain 
in the bowels. 

In disease of the brain, the child utters short, sharp, 
piercing shrieks, and after each outcry relapses into its 
former drowsiness until again aroused by pain. 

In fevers, children do not cry long, even though they 
may be distressed by much pain. 

HJarache is the cause of the most prolonged, obstinate, 
and violent crying, which persists in spite of all efforts 
to relieve the pain or divert the attention. This cry 
is readily distinguished from most others, by the 
length of time during which it lasts without any 
intermission. Next in persistency to the cry produced 
by the torture of earache, is that which attends hunger. 
The cause of violent crying difficult to explain may 
often be solved by placing the infant at the breast. 
Children also cry loudly and long when wounded or 
bruised, or when suffering from an abscess. 

In affections of the upper air-passages the cry is 
hoarse, or may be suppressed altogether. In cases of 
great debility, also, the child is sometimes unable to 
utter a cry, although it may make the attempt. 

The general irritability and fretfulness which fre- 
quently attend sickness or slight ill-health in children 
often manifest themselves in fits of crying, excited by 
moving, dressing, or even looking at the little one. 



368 THE NURSING OF CHILDREN. 

Crying of this description can usually be appeased by 
gentle care or amusing toys. 

We have already spoken of the shedding of tears and 
the signification to be attached thereto. It must be 
recollected that the tears are not formed before the 
third month, so that before that age their absence is 
natural, and not a sign of any sort. 

THE COUGH OF A SICK CHILD. 

The cough of a child may merely denote some slight 
trouble, such, for instance, as a passing catarrh without 
fever, a transient ordinary cold, the presence of worms 
in the bowels, or the cutting of teeth, but it may also 
signal the approach of a serious disease. The character 
of the cough is an index to the nature of the disease. 

In an ordinary cold, the cough is dry for the first 
twenty-four hours, and then becomes loose, the rattle of 
the phlegm in the upper air-passages being plainly 
heard. As a young child cannot spit, this being an art 
which even the American boy has to learn, the phlegm 
is raised into the mouth and swallowed. As the air- 
passage is cleared of the secretion in this way, the 
same object is attained as if the child expectorated in 
the manner of grown persons. In the ordinary cold of 
which we speak, the cough is free, loud, and without 
pain. 

In an inflammatory affection of the lungs, the cough is 
attended with pain, distorts the features, and is low 
and smothered. 

In croup, the cough, once heard by the mother, will 



SI0-NS OP DISEASE IN CHILDHOOD. 369 

never be forgotten. "Would that all mothers were 
capable of recognizing it at once, in order that they 
mig-ht in time take measures to avert this terrible and 
insidious disease of early life. The cough of croup 
has been compared to the bark of a dog; it is very 
hoarse, dry, loud, and metallic, and is made when the 
air is expelled from the lungs, in this respect differing 
from the cough of whooping-cough, which is made 
when the air is inhaled. A change in the voice accom- 
panies the earliest stages of croup. At first hoarse, it 
becomes afterwards muffled, and finally almost extin- 
guished. It must be borne in mind that there are two 
varieties of croup, the true and the false. The latter 
is a nervous affection of the upper part of the main air- 
passage, and never of itself causes death. It is distin- 
guished from true croup by the following character- 
istics : it makes its appearance suddenly towards the 
middle of the night, may be in the midst of perfect 
health or during the course of an ordinary cold. Pale, 
nervous children, especially when teething, are more 
particularly liable to it. True croup, on the contrary, 
is attended with the formation of a membrane in the 
throat, and is a very dangerous affection. Fortunately 
it is much more rare than false croup. It is preceded 
by several days of ill-health and fever, with the changes 
in the voice, and the peculiar hoarse, hollow cough we 
have described. 

In measles, the cough is ringing and often hoarse, 
but differs widely from that of croup. It is attended 
with a discharge from the nose, and with redness, 
almost a bloodshot condition, of the eyes, which are 

24 



370 THE NURSING OF CHILDREN. 

filled with tears. The appearance of the eyes and nose 
is the most significant sign of the disease. 

In whooping-cough, the peculiar cough which gives 
its name to the disease does not show itself until be- 
tween three days and two weeks after the first appear- 
ance of the symptoms. Previous to this time the cough 
cannot be distinguished from that which is present 
during an ordinary cold. The characteristic long, jerk- 
ing cough, interspersed with a loud, sucking, drawing 
in of the air, known as the " hoop," and ordinarily 
followed by vomiting, is known to every mother. 
"When heard, it places beyond doubt the nature of the 
disease. 

In scrofula there is commonly a short, dry cough, 
which is heard at intervals during the day and night. 

Coughs of long duration are always dangerous. If 
they be accompanied with loss of flesh, there is reason 
for serious alarm. No time should be lost in obtaining 
intelligent advice, for in all probability that terrible 
foe to human life, consumption, is making its first 
advances. The mother who indulges the hope that the 
long-continued cough is due to worms, teething, etc., 
without seeking the opinion of the family physician in 
the matter, may find that she has been nursing a 
delusion fatal to her child. 



THE PULSE OF A SICK CHILD. 

In infancy and early childhood, the feeling of the 
pulse is far more difficult than in more advanced life. 
So difficult, indeed, is the task, that it requires the 



SIGNS OF DISEASE IN CHILDHOOD. 371 

educated touch of the physician to properly appre- 
ciate variations in the frequency, force, and regularity 
of the beat. 

The pulse in children is much more frequent than 
in adults; it is also much more readily influenced by 
disordered health, position, excitement, and motion. 
It is, therefore, a very uncertain guide, particularly 
to the unskilled finger. 



TAIN. 

In speaking of the expression of the face, as fur- 
nishing a guide by which to distinguish disease, we 
pointed out the manner of telling the nature and 
degree of the pain suffered, by the countenance and 
motions of the child. The signs of pain will be 
transient or permanent, according as the pain itself is 
intermittent or constant. The cries, also, as we have 
pointed out, are indicative of the character of the 
suffering, and, hence, of the disease producing it. Of 
all the signs of the presence of disease in a child, pain 
is the least likely to escape notice, for children are 
not stoics, and never suffer in silence. 



FEVER. 

A hot skin is one of the earliest signs of deranged 
health, but the occurrence of fever in young children 
may be of serious import, or may mean nothing at all. 
There are some children who have readily a slight 
fever excited by a very trifling cause — too long a 



372 THE NURSING OF CHILDREN. 

walk, a fright, a change of food, etc., will bring it on 
in those feverishly disposed. All diseases, at this 
early age, quickly light up a fever in the system; 
indeed the great physiological activity which is 
present almost borders upon a condition of feverish 
excitement. 

"We must, therefore, inquire in each case, whether the 
fever is severe or accompanied with other symptoms, 
before we permit ourselves to be alarmed about the 
welfare of the little one. If the undue heat of skin 
be not attended with headache, nor cough, nor other 
grave symptom, it will probably pass away in the 
course of ten or twelve hours. If there exist in the 
neighborhood any cases of chills and fever, and if the 
attack has commenced with a chill, the child has 
probably that disease, and proper treatment should be 
instituted. 

If the fever persist beyond ten or twelve hours, it 
becomes probable that some eruptive disease — measles, 
scarlet feverj chicken-pox, or smallpox — is coming on. 
If the fever be accompanied with nausea or vomiting, 
with a ringing cough, suffused eyes, and running 
from the nose, it is probably an attack of measles. 
If the fever have been preceded by chills, if there 
exist much headache, intense heat of skin, sore throat, 
and a very quick pulse, it is likely that the case is one 
of scarlet fever. If the fever be very high, with vague 
muscular pains particularly situated in the lower part 
of the back, and there be an absence of the peculiar 
signs of measles and scarlet fever, some form of 
smallpox or varioloid may be anticipated. The actual 



SIGNS OF DISEASE IN CHILDHOOD. 373 

existence of one of these eruptive diseases in the 
vicinity aids greatly in recognizing the meaning of 
these early signs. 

As for serious fevers of long duration, such as ty- 
phoid and the like, they are announced from afar by 
persistent troubles of the digestive and nervous 
systems, which can scarcely fail to excite alarm and 
lead to the summoning of the family physician. 

In order to recognize the presence of f ever, the pulse 
is not a sufficient guide for the mother, she must 
habituate herself to note the heat of the skin by 
placing the hand on different parts of the child's 
body. A little practice will enable her quickly to 
observe any undue elevation of temperature. The 
left hand being more sensitive to heat, should be 
employed for this purpose rather than the right, which 
has the acuter sense of touch. 

Children are frequently noticed to have particular 
parts of the body alone very hot, the temperature of 
the rest not seeming raised. The palms of the hands, 
for instance, will attract attention by their burning. 
This may be merely due to too much mental excite- 
ment or over-fatigue, but should excite the watchful 
care of the mother to remove the cause. Heat -of the 
head may be occasioned in the same way as by teeth- 
ing, and, when unaccompanied by other symptoms, 
requires only rest, quiet, and bathing with cool water. 
The feet are prone to be too cold rather than too hot. 
Coldness of the feet is noticed in colicky and other 
affections of the bowels, and is habitual in pale, 
feeble, and scrofulous children. 



374 THE NURSING OF CHILDREN. 

In addition to the observance of the temperature of 
the skin, the mother should be ready to detect any 
changes in the color, any unusual dryness or moisture, 
and the presence of any eruptions or swellings. The 
daily bath affords an opportunity for the careful 
scrutiny of the whole surface of the young child's 
body, which should not be neglected. 



DISTURBED SLEEP. 

In health a child sleeps quietly and soundly. This 
peaceful sleep is easily disturbed by the slightest 
disorder. Its calm is then broken by restlessness and 
cries, and either the child wakes or continues to doze 
in this uneasy manner. While very slight causes, 
such as the cutting of a tooth, an overloaded stomach, 
or a little fever, are sufficient to interrupt the sleep at 
night, one of the earliest symptoms of serious maladies 
is this tossing and wakefulness, so distressing to the 
mother. From the disturbed sleep alone it is not 
possible, of course, to tell the exact ailment which is 
present or threatened, but merely that there is some- 
thing wrong; the other signs which accompany this 
point to the character and degree of the disease. 



THE TONGUE OF A SICK CHILD. 

This organ has been described as the "mirror of the 
stomach," an accurate reflector of what is passing in 
the digestive tract. But its importance has been 
exaggerated. Certainly in America there are few 



SIGNS OF DISEASE IN" CHILDHOOD. 375 

children or adults without, when in their best health, 
a tongue more or less coated. Again, in certain 
diseases of the bowels it is not uncommon to find the 
child's tongue presenting its natural red color. Still, 
any marked variation from the usual condition of the 
tongue should excite the suspicion that there is some 
trouble in the stomach or elsewhere. It is well to 
teach a child to put out its tongue when told, other- 
wise, when ill, the attempt to see it on the part of the 
doctor may lead to an exciting and more or less 
injurious struggle. Some children learn this lesson 
so well, that the approach of the family physician, 
even on the street, is a signal for protruding the tongue 
at him, more to the amusement of the passers-by than 
of the doctor. 



THE MANNER OF DRINKING. 

The way in which an infant nurses, and in which 
they and older children drink, affords a valuable 
indication to the watchful eye. The refusal of the 
nipple, or the letting go of it with a cry, although the 
child is evidently hungry, points to the existence of a 
sore mouth. Soreness of the throat causes the child 
to swallow in a gulping manner, and excites cough. 
In diseases of the chest and air-passages, the child 
will not nurse regularly, but stops frequently to get 
its breath. 

In drinking, a child when in health naturally drains 
the cup without pausing to breathe, when suffering 
from inflammatory diseases of the lungs it swallows 



376 THE NURSING OF CHILDREN. 

only a few mouthfuls at a time, being unable to retain 
its breath longer. If the child drink slowly and with 
evident pain, but without any embarrassment of the 
breathing, then there is probably some trouble in 
the throat which interferes with the passage of the 
fluid. A dry mouth, together with a desire to drink 
frequently and much, shows a feverish condition of 
the system. 

THE APPETITE. 

Whatever may be the nature of the disease from 
which a child is about to suffer, loss of appetite will 
ordinarily be one of the earliest symptoms to attract 
attention. This, associated with increased thirst and 
heat of skin, restlessness at night, general fretfulness, 
and indisposition to play or exertion, will be found 
among the commonest premonitory signs of illness. 



THE BELLY. 

A big belly in a thin child excites alarm in the 
mind of the mother, who fears all she has ever heard 
of the dangers of marasmus. Nevertheless, this dis- 
tension of the abdomen is often due merely to too 
much wind in the bowels, to which children reduced 
by illness are particularly liable, owing to the weak- 
ness of the abdominal walls. It may also be occa- 
sioned by displacement of the liver or spleen, which 
often occurs in rickets ; this can only be recognized 
by the physician. As a rule, flatulence, the accu- 



SIGXS OF DISEASE IX CHILDHOOD. 377 

mulation of air in the bowels, is the cause of the 
big belly in delicate children. There is no reason, 
therefore, for anxiety. In such cases the bowels are 
deranged, and the food being badly digested, sets free 
by its decomposition the gas which produces the 
swelling and discomfort. 



VOMITING-. 

Children vomit much more frequently than older 
persons. The reason of this is that the stomach is in 
early life less curved than it becomes in after years, 
hence it more easily rejects its contents. The vomit- 
ing of infancy and childhood is as often an evidence 
of slight indisposition, resulting from too much milk 
from a full breast or too much food eaten at the table, 
as it is of any serious ailment. 

The throwing up of milk by an infant at an abun- 
dant breast is hardly to be termed vomiting, it is 
more properly the overflowing of the completely filled 
stomach. In these cases the milk is not changed, but 
is returned not at all or but slightly curdled. Such 
a condition of affairs cannot excite any alarm, the 
remedy is to guard against the over-distension of the 
stomach. 

"When, however, the vomiting is occasioned by the 
cramming of the stomach with more food than it can 
digest, the health may be disordered by the resulting 
disturbance. The presence of bile in the vomited 
matter merely shows that the contents of the stomach 
are well emptied, and that the bile is forced into that 



378 THE NURSING OF CHILDREN. 

organ by the effort attending the straining. All that 
is to be done to overcome such "biliousness" as this 
is to stop the vomiting. The proper method of doing 
this will be mentioned in the third part of this book, 
when discussing the diseases of children and their 
treatment. We are merely now concerned with the 
meaning of vomiting as a symptom. 

When the child appears relieved after the vomiting, 
there is no need for any medication for the trouble ; the 
over-distended stomach has been remedied by the emp- 
tying of its contents ; when, however, the vomiting is 
repeated at short intervals, when the retching is se- 
vere, the child weak and white, or the skin hot, then 
this symptom points to some ailment demanding atten- 
tion. It may be the first indication of the presence of 
an eruptive fever, or of disease of the drain, or it may 
show some dyspeptic or inflammatory condition of the 
stomach. The cause should be diligently sought by 
observing which of the other signs of disease, we are 
now engaged in detailing, are present. 

THE PASSAGES OF A SICK CHILD. 

The mother should bear in mind that the infant has 
naturally from two to three passages a day in a state 
of health. It is only when the child varies from its 
habit — of one or three passages in the twenty-four 
hours, as the case may be — that there is any sign of 
deranged health. 

Diarrhoea is a symptom of too much or improper 
food, of a disordered condition of the mother's milk, 



SIGNS OF DISEASE IN CHILDHOOD. 379 

of trouble with teething, of too great heat of the atmos- 
phere, and of various fevers. It occurs during the pro- 
gress of measles and scarlet fever in many cases, but, 
unless too protracted, is not then necessarily a serious 
symptom. Slight looseness of the bowels, with colicky 
pains, is one of the earlier signs of typhoid fever. 
When diarrhoea is watery and accompanied with 
vomiting, medical advice is required, for there is 
danger the disease may be cholera infantum. The 
finding of blood in the stools indicates there is some- 
thing more than diarrhoea — that the case is one of 
dysentery. 

The color of the stools is to be noticed. In health 
they are brown, or if the diet be milk only, of a golden- 
yellow color. Green stools occur during teething, and 
after any slight diarrhoea produced by undigested food. 
The normal form of the discharge from the bowels in 
early life is pappy : the smell is never pungently offen- 
sive, except where children are allowed a meat diet. 



CONVULSIONS OR PITS. 

"What is the meaning of fits in children? Do they 
always indicate disease of the brain, and is there a 
just cause for the alarm they usually excite in the 
mother? 

Fits in early life take place under very various cir- 
cumstances. They sometimes portend a serious brain 
affection, they may merely result from the cutting of 
a tooth, from a slight fright, from the presence of some 
indigested food in the stomach. 



380 THE NURSING OF CHILDREN. 

"When a fit is occasioned by disease of the hrain, it 
will ordinarily be found that both sides of the body 
are not alike affected, the arm and leg of one side 
being in active motion, while the other is quite still. 
After the fit has passed off, the side of the body which 
was not in motion will probably be seen to be rela- 
tively or entirely powerless, the limbs supple, easily 
drawn up and down by another person, but, if left 
alone, bent upon themselves, the forearm upon the 
arm, the fingers upon the palm of the hand. After 
such a fit as this, consciousness will not return to the 
child at once. When partial or complete palsy of one- 
half of the body remains after the fit, there is, without 
doubt, some disease of the brain-structure. 

The mother should know that the occurrence of a 
fit is not often the first sign of brain disease, but 
usually follows other symptoms which have existed 
for some time, such as dislike to light and noise, fret- 
fulness, disturbed sleep, vitiated appetite, nausea, and 
vomiting, with constipation of the bowels, headache, 
dizziness, and heat of the head. All or many of these 
evidences of disordered health will have existed for 
some time, and excited attention and alarm, before the 
coming on of the fit. 

When a fit comes on suddenly, of its own accord, 
as it were, in a child in its apparently usual health, it 
need not occasion much alarm. It is doubtless the 
effect of some trivial cause, the pain, perhaps, of a 
tooth just passing through the gums. In many 
children, an attack of catarrh of the chest is always 
ushered in by a fit, so also are frequently measles and 



THE CHAMBER OE THE SICK CHILD, 



381 



scarlet fever, the convulsions ceasing on the appear- 
ance of the rash. In fact, owing to the impressibility 
of the nervous system in childhood, fits are very 
readily excited by almost any cause which awakens 
emotion, pain, or disordered action of any part of the 
body. Hence, they are not nearly as grave a sign of 
disease as in adult life. 

We have now passed in review some of the most 
prominent symptoms which present themselves when 
a child is ill, and have endeavored to show the diseases 
which they more particularly indicate. The con- 
sideration of these diseases themselves finds a proper 
place elsewhere. Their prevention has already been 
discussed in part first of this volume, their home 
treatment will be given in part third, under "Diseases 
of Children." 

Having thus, to the best of our ability, enabled the 
mother to tell when her child is sick, we proceed now 
to help her in caring for her sick child. 



II. The Chamber of the Sick Child. 

In the care of a sick child, little things often deter- 
mine great results. It is by attention to trifles, 
humble and minute though they may appear, that the 
comfort and safety of the little sufferer are secured. 
The doctor prescribes, the mother or the nurse exe- 
cutes, and in proportion to her intelligence and devo- 
tion will be the measure of success in the attempt to 
restore health. 

The task of properly managing the room of the 



382 % THE NURSING OF CHILDREN. 

sick child is no easy one. It requires knowledge and 
tact ; it is an art, and a most useful one. "What is here 
required of the home nurse ? It is necessary for her 
to maintain perfect order and the most scrupulous 
cleanliness in the midst of much calculated to inter- 
fere with both; to prevent noise; to renew and purify 
the air; and to regulate the amount of light and heat. 
These various duties we shall consider in detail. 
First, then, as to 



ORDER AND CLEANLINESS IN THE ROOM OF THE 
SICK CHILD. 

It is said that the love of order is peculiarly a 
feminine trait. !Nb mother destitute of it can give 
proper attention to her child during its illness. At 
this time of all others, in the sick chamber of all 
places, this quality is imperatively demanded to see 
that everything is in its place, that the most is made 
of space and time, and that regularity and systematic 
diligence are observed. 

The room should contain nothing for which there is 
no need. Useless objects should not be allowed to 
accumulate on the tables or mantles, hence glasses, 
cups, and bottles not in actual service are to be re- 
moved. A small table, covered with a white cloth 
and placed at one side or in a corner of the room, 
makes the neatest and most convenient receptacle for 
the medicine bottles, the iced or warm drinks, the 
lotions, etc., which are in constant demand. Here, 
systematically arranged, they can readily be found 



THE CHAMBER OF THE SICK CHILD. 383 

when the hour, the symptom, or the desire of the 
patient calls for them. Every physician knows what 
a pleasure it is to enter a sick-room which is thus 
prepared; he feels that he is not alone in combating 
the disease, but is sustained in his efforts. Too often 
is he not only unaided, but obliged also to contend 
against the effects upon his patient of negligence, 
forgetfulness, and thoughtlessness on the part of the 
attendants. 

Cleanliness is ordinarily found hand in hand with 
order. If cleanliness be necessary to preserve, it is 
doubly so to restore the health of children. "We 
speak here now only of the cleanliness of the chamber. 
Elsewhere we will discuss the importance of cleanli- 
ness of the bed and person of the child. The air of 
the room should be free from the slightest odor. This 
can be effected by means of proper ventilation, the em- 
ployment of disinfectants, and by removing promptly 
from the apartment all evacuations and soiled linen. 

THE VENTILATION OF THE ROOM OF THE SICK CHILD. 

It has been advised, as the best method of main- 
taining the purity of the air, to have two chambers 
communicating the one with the other. "When this is 
possible, the circumstances are, doubtless, the most 
favorable, for the child can always be readily carried 
in the arms, or when much exhausted its little bed 
may be pushed, from one room to the other. In the 
morning, it is moved into one of the rooms for the 
day, and the communicating door closed. The windows 



384 THE NURSING OF CHILDREN. 

of the room which it has left are then opened and the 
fresh air admitted; the child returns here to pass the 
night, after the temperature has been first carefully 
raised to the proper point. Unfortunately this most 
desirable arrangement, of two adjoining rooms, is not 
always practicable. 

"When a single room is all that is at the disposal of 
the family, the air in it should be changed several 
times a day. This may be done with safety to the 
child by covering it up and protecting it from drafts. 
The fresh air is always beneficial; it is only currents 
of air which are injurious. Particularly in cases of 
fever is it of the utmost moment to renew the air, and 
thus prevent the child from being poisoned by its own 
emanations. 

The temptation which presents itself to the mind of 
many a nurse upon noticing unpleasant odors or a 
sensation of closeness in the sick-room, is to remove 
this by deodorizing the apartment, L e., by the em- 
ployment of some fragrant perfume. Perhaps this 
process will be dignified by the name of disinfection. 
Now, to deodorize the air of a room is not to disinfect 
it. A bad smell is only masked by a deodorizer; the 
offending matter remains in the atmosphere, its pre- 
sence is merely concealed. A disinfectant, on the 
contrary, decomposes the noxious matter and renders 
it inert; but it cannot restore to the air its chemical 
purity, its oxygen, its vivifying properties. The best 
way, therefore, both of deodorizing and disinfecting 
a room, is to renew the air in it, to replace the vitiated 



A CAUTION TO NURSES AND VISITORS. 385 

and poisoned atmosphere by that which is fresh and 
pure. 

A sick-chamber, well cared for, ought to have no 
odor. To conceal an odor by burning camphor, sugar, 
vinegar, or by sprinkling upon the bedclothing or dif- 
fusing throughout the air the vapor of cologne- water, 
etc., is not to purify the air, but only to substitute a 
pleasant for a disagreeable scent. The most grateful 
and healthful of smells is the absence of all. 

In this connection, a useful suggestion occurs. 
Highly scented flowers, and very odorous medicines, 
such as musk, valerian, assafcetida, should not be suf- 
fered to remain in the room. The sensitive nervous 
systems of children are readily affected by powerful 
perfumes ; even the fragrance of cologne-water is often 
too decided, and productive of harm. 

All nurses should avoid the use of powerful per- 
fumery. Every sick-room visitor should also bear 
this caution in mind, in order not to contaminate the 
atmosphere of the sick child with the odor of a fash- 
ionable essence, or of tobacco. 



THE NECESSITY FOR QUIET IN THE ROOM OF THE SICK 

CHILD. 

The room is to be carefully kept free from noise. 
The ceaseless chatter of injudicious visitors, the loud 
sports of boisterous children, and the raised tones of 
voice in conversation of the members of the family, 
may undo the effects of the most skilful medical 
treatment. 

25 



386 



THE NURSING OF CHILDREN. 



In many affections of young children sensitiveness to 
sounds is strongly developed, and those noises which 
would not be noticed in a condition of health make 
hurtful and dangerous impressions. For this reason, 
heavy footsteps which shake the floor of the chamber, 
the creaking or the slamming of a door, the monotonous 
loud ticking of a clock, the shouting of directions from 
one part of the house to the other, the rattle of spoons in 
cups or glasses, the rustle of a silk dress, the turning 
of a newspaper — all these may agitate the mute suf- 
ferer and deprive it of sleep. Particularly in disorders 
of the brain is it important that quiet be preserved in 
the room and throughout the house. Then all neces- 
sary talking should be carried on in a voice " soft, 
gentle, and low," not in a whisper, which is apt to 
disturb the patient; and all necessary movements about 
the room should be made by treading carefully^ not on 
tiptoe, which is a fussy and insecure way of walking. 
The child must be spoken to gently, its attention being 
secured by addressing it affectionately with some 
familiar term of endearment. 

There is one method of securing quiet to the sick 
child, to which little attention has been called. "We 
recommend it to all mothers. It is simply by placing 
cotton in the ears.' In this way it is much easier 
to shut the ears of the child than to close the mouths 
of well-intending visitors, who come to offer their 
assistance, and to discuss the symptoms of the case 
and of similar cases at the bedside. Deafness is 
often the only possible remedy against the intermina- 
ble talk of such persons. This is also a ready method 



THE EFFECT OF A LIGHT ROOM. 387 

of shut-tine: out from the excitable brain the usual or 
extraordinary noises occurring upon the streets. This 
simple recommendation Avill, under many circum- 
stances, be found of extreme practical value, particu- 
larly when the house or neighborhood is necessarily 
noisy. 

THE AMOUNT OF LIGHT IN THE ROOM OF THE SICK 

CHILD. 

The question as to the proper amount of light in 
the room may be answered thus : in diseases attended 
with fever and nervous excitement, partial darkness is 
required; in long-standing diseases, attended with 
pallor and debility, as well as during convalescence, 
the room should be flooded with light. 

Light is an excitant. It excites by its action upon 
the skin, and by the impression it makes upon the 
brain through the sense of vision, which impression 
is then communicated to the whole nervous system. 
Diseases, therefore, which are characterized by deli- 
rium, wandering of the mind, great nervous irritability, 
and much fever, ought to be cared for in a darkened 
room; not one from which all daylight is excluded, but 
where an artificial twilight is made by partially closing 
the blinds and shutters. The bed should be so situated 
that both during the day and night the child's face 
may be turned from and not towards the light, if it so 
desire. 

The lighting of the chamber during the night is a 
matter deserving more thought than is usually given 
it. The lamp or gas-jet should be so disposed as to 



388 THE KITRSING OF CHILDREN". 

permit of the patient being seen without the danger 
either of dazzling its eyes, or of throwing upon the 
wall or ceiling shadows which may frighten a mind 
weakened by fever and delirium ; care must be taken 
also that the purity of the air be not interfered with 
by a smoking flame or the escape of unconsumed gas. 
Even persons in health would suffer from the effects 
of the acrid, irritating, and disagreeable products of 
the flame of a badly-cared-for lamp burning during 
the night ; the respiration of these products, by a sick 
child, provokes cough and induces fever. 

"We have already spoken of the precautions to be 
taken in placing the lamp. Its proper position in the 
room can only be determined by experiment. It not 
unfrequently happens that children are observed to lie 
with their eyes fixed on the ceiling, showing, by their 
emotion, evident signs of fear. A shadow projected 
upon the ceiling by some object in the room, takes to 
their alarmed gaze fantastic proportions and shapes, 
and is the cause of nervous agitation. If the shadow 
be that of a person in the room, its movements, from 
side to side, may so increase the terror as to bring on 
an access of delirium. 

When our little patient is on the road to recovery, 
or when the disease is not an active one, but of long 
duration, then the sun is not an unwelcome visitor to 
the sick-chamber; it becomes a friend in need, a healer 
of great power. No medicine can replace it in slow 
diseases or during convalescence. Allow it, therefore, 
free access. An Italian proverb says, "Where the 
sun enters not, there the physician is wanted." And, 



TO REGULATE THE AMOUNT OE HEAT. 389 

again, "All diseases come from the shade and are 
cured in the sun." These expressions are too forcible 
and general, as we have pointed out, but, bearing in 
mind the exceptional circumstances mentioned, they 
express with justice the usefulness of permitting the 
light to penetrate all parts of the sick-room. 

THE TEMPERATURE OF THE ROOM OF THE SICK CHILD. 

It does not require much medical knowledge to see 
the necessity of regulating the temperature of the air 
surrounding a child burning with fever or harassed 
by a painful cough. The feelings of no one can be 
trusted in this matter, a thermometer must he consulted. 
This instrument should be kept at a distance from the 
fire, and be placed at the same height as the bed, in 
order to ascertain the exact degree of warmth of the 
air which the patient breathes. 

In cases of cough, a room too cold will not only 
increase the frequency and severity of the attacks of 
coughing, but will very likely add to the trouble in 
the bronchial tubes or the lungs. In such cases the 
temperature should not be lower than 60 degrees. 
The air drawn into the lungs when they are inflamed 
ought to be warm, in order not to augment the distress 
of breathing. The patient must not, however, be 
covered too heavily with bedel othing when the skin 
is heated by fever. A room comfortably warm, and 
light coverings for the bed, are the most conducive to 
the well-being of the little one. 

In general, there is a tendency in winter to keep 



390 THE NURSING OF CHILDREN. 

the sick-room too warm rather than too cool, and, 
in addition, to multiply to too great an extent the 
number of clothes on the bed. From sixty to sixty- 
five is ordinarily the proper degree of warmth. In 
those cases, however, in which the brain is disordered, 
the thermometer, hung away from the fire and out of 
a draft, ought to be kept as low as fifty-five degrees. 

The chamber of a child sick in the winter, ought 
to have a southern exposure, which is especially 
needed during convalescence. 

Care must be taken in selecting the chamber for 
the child, that one be chosen of which the chimney 
does not smoke. It has been said that a good chim- 
ney is nearly as invaluable as a good friend; both are 
rare, and both can only be recognized in the use. An 
open fireplace is most to be desired, for it acts as a 
means of ventilation. 

The temperature of the room should be kept as 
nearly uniform as possible. This is difficult, owing to 
the variation in the number of persons in it, the pre- 
sence or absence of the sun on the windows, the opening 
and shutting of the doors, and the change in the fire. 
Still, by a close observation of the thermometer and an 
attentive general oversight, this end can be nearly 
accomplished. 

In most active diseases, particularly where there is 
fever, the thermometer should be kept at about sixty, 
as we have said. This degree of w r armth does not 
interfere with the action of the lungs nor congest the 
head, while it leaves the skin ready to respond to any 
tendency toward perspiration ; moreover, the child may 



TO COOL THE AIR IK THE ROOM. 391 

partially uncover itself without risk of taking cold. 
"When, however, it is designed to excite perspiration 
or to combat an inclination to chilliness, the tempera- 
ture may be elevated to seventy degrees or over. But 
the physician is the judge of the necessity for so high 
a temperature, and will direct it when proper. 

In southern climates, or during the summer in the 
north, it is often necessary to cool the air in the interior 
of the chamber. This task is more difficult than the 
opposite, of warming it. The opening of a window, 
instead of cooling the room, renders it warmer by 
admitting the sultry air from without. There is no 
resource excepting in a current of air established 
between two openings, the bed, well guarded, being 
removed from the draft. 

There are two methods of cooling the air artificially: 
one by evaporating water, the other by melting ice. 
"When it is desirable that the air be made both moist 
and cool, this can be effected by suspending in the 
chamber a large well-moistened piece of cloth. The 
physicians of olden times caused odorless green 
branches covered with their leaves to be placed in the 
rooms of their patients, in order at the same time to 
purify the air, to cool it, and to please the sight of the 
sick. 

A simple and inexpensive way of cooling a room 
during hot weather is by means of flat vessels or 
dishes filled with ice. "When a sufficiently low tem- 
perature is obtained, the refrigerating dish is removed, 
to be brought back when the warmth becomes greater 
than is desired. 



392 THE NURSING OF CHILDREN. 

VISITORS TO THE ROOM OF THE SICK CHILD. 

But few visitors should ever be admitted — never 
many at a time. The door of the sick-room ought to 
be closely shut against all those who have not some 
useful office to fill within. The crowd of indiscreet 
visitors who like to seat themselves for hours at the 
bedside, resemble the mob that rush to a fire; they are 
of no service, and do much harm by their officious and 
meddlesome conduct. We do not wish to decry sym- 
pathy, nor check its manifestation; it is one of the 
purest and noblest of human feelings. But that sort 
of sympathy which never finds expression in any use- 
ful form, which is indiscreet and noisy, should be 
forced to content itself with inquiries outside of the 
sick-room. 

III. The Person of the Sick Child. 

A sufficient amount of attention is not ordinarily 
paid to preserving the cleanliness of the person of 
the sick child. Children who are bathed daily when 
well, often go for twenty-four hours with unwashed 
hands and face when ill. It would seem that there is 
a natural want of compatibility between sickness and 
the sponge. On the appearance of disease, the use of 
water ceases. In consequence, the skin, badly cared 
for, acts in an imperfect manner ; the soiled face has 
an unnatural complexion, and those prominent parts 
of the body upon which the child rests in bed are apt 
to become sore. 



BATHING OF THE SICK CHILD. 



393 



A well washed and combed child is the glory of a 
mother, in whatever condition of life she may be. She 
ought to take more pride and care in these matters 
when her child is ill than when well, for her responsi- 
bility is greater. The cheeks of the sick babe tell at 
a glance the tale of negligence or watchful solicitude 
on the part of the mother. 

But why is there this strange want of attention 
to proper ablutions during the sickness of children ? 
Carelessness and ignorance account for it in some 
measure. These are inexcusable. But, beside these 
causes, there is a wide-spread prejudice against the 
use of the sponge or wet towel and the cleansing bath 
during sickness. Mothers fear the enfeebled child will 
"take cold." This fear is unfounded, if proper pre- 
cautions be used. 



BATHING. 

The treatment of every disease, unless forbidden by 
the doctor, ought to be begun by a warm bath. It is 
easy to bathe a child. This easy remedy should be the 
first employed on the appearance of illness. It secures 
the free action of the skin and allays febrile excite- 
ment. 

But, it will be asked, shall the child be bathed during 
the course of a sickness ? With proper care to guard 
against undue exposure of the person, the warm bath 
is a measure of the greatest utility. "When one thinks 
of the comfort it brings to a child exhausted by want 
of sleep and parched by fever, and recalls the impor- 
tance of maintaining the skin as nearly as possible in 



394 THE NURSING OP CHILDREN. 

a condition- of physiological activity, he cannot bnt 
regret that a remedial resource so precious is not more 
frequently invoked. 



HOW TO BATHE A SICK CHILD. 

It may be said that the child is frightened at the 
sight of the bath, and that its screams and struggles 
do it more harm than the bath does good. "We answer, 
there is no occasion for any such terror, and that all 
this excitement may readily be avoided. When the 
child has a repugnance to the water, as is sometimes 
the case, the bath-tub should not be prepared in the 
room, and placed with its cloud of steam at the bed- 
side of the frightened little one. The bath ought to 
be got ready out of the sight of the unwilling patient. 
"When ready, bring it into the room, covered with a 
blanket to conceal the water and prevent the steam 
from rising. If the child be very fearful, it need not 
be undressed, but placed gently upon the blanket and 
lowered into the water. Some corks with feathers, or 
other floating playthings, put beside it in the water, 
will make the baby quite happy. A little manage- 
ment of this kind will deprive the bath of all its 
terrors. If any tears be shed, they will fall upon 
leaving the tub, not on entering it. 

The temperature of the warm bath should be from 
ninety-five to ninety-eight degrees. The thermometer, 
not the hand, is to be used to determine the proper 
degree of heat. Care must be taken, by the addition 



TO PREVENT EXCORIATION IN DIARRHCEA. 395 

of warm water, to prevent the bath from cooling while 
the child is in it. 

Children affected with diarrhoea require especial care. 
Unless this be observed, the skin is apt to become 
inflamed and sore. The use of soap and water is not 
all that is required; indeed soap is very likely to irri- 
tate the skin, and in these cases had better be em- 
ployed very sparingly or not at all. Thin starch — 
much thinner than that used for wash-clothes — is soft, 
soothing, and cleansing to the tender skin. After 
drying the parts carefully by patting with a soft cloth, 
if they be very red and sore, they should be dusted 
with zinc powder. For this purpose obtain some pre- 
cipitated carbonate of zinc from the druggist — not cala- 
mine powder, which is an impure carbonate of zinc. 

Children affected with rashes are supposed to be 
particularly liable to take cold or have the rash driven 
in if the surface of the body be washed or the linen 
changed. So far is this from being true, that even in 
cases of measles, in which there is usually the most 
fear, there is not a particle of danger of this sort if 
lukewarm water be employed, and only a part of the 
surface of the body exposed at one time. The passing 
of a damp sponge over the heated skin is a most agree- 
able and harmless application when the little sufferer 
is burning hot with fever. The body clothing re- 
quires changing more frequently in fevers than almost 
any other affections. 



396 THE NURSING OF CHILDREN. 



THE COLD, THE WARM, AND THE HOT BATH. 

Baths are employed in the sickness of children, not 
only for purposes of cleanliness, but also as remedies. 
They may be cold, warm,, hot, or medicated. 

The cold hath is used in the treatment of St. Titus' 
dance and scarlet fever; of this we shall speak in the 
chapters devoted to the consideration of these dis- 
eases. As a preventive of croup, a morning bath, in 
water which has stood in the room over night, is an 
excellent prescription, provided the child is allowed to 
remain only a minute, and is then briskly rubbed and 
quickly clothed. 

The warm hath is a safe and most valuable remedy 
in an attack of croup. It should be resorted to at 
once. The water of about 96° when the little one is 
first immersed in it, should be raised, by adding hotter 
water, to 98° or 100°. The bath is to be continued 
for fifteen or twenty minutes. Whenever a child has 
a fit, place it in a warm bath, and keep it there for a 
quarter of an hour, or until the fit is over. No harm 
can result from this; no remedy is safer or better. In 
measles, warm bathing is agreeable and efficient. 

The hot hath is of service in the dropsy which 
sometimes follows scarlet fever. 



MEDICATED BATHS. 

These are baths to which sulphur and other articles 
are added; they are useful in various cases. They will 



THE CHANGE OF UNDERCLOTHING. 397 

be considered in the next chapter, and exact receipts 
given (for page, see index). 

The bath and the sponge ought never to be long 
absent from the sick-room of a child. A clean skin is 
even more necessary in disease than in health. 



THE LINEN OF A SICK CHILD 

Ought to be frequently changed. Physicians find it 
necessary to combat daily the prejudice against 
changing the linen, especially when the little patients 
are covered with perspiration. At this time, above 
all others, is a renewal of the linen called for two or 
even three times during the day. The fear of sup- 
pressing the perspiration is gratuitous ; indeed, per- 
fectly dry clothing placed next the skin will excite 
it the more, by presenting a tissue capable of absorbing 
moisture, and by preventing the sensation of cold, 
which is produced by that which is wet with perspira- 
tion. 

During an attack of an acute disease, the linen of a 
child ought to be completely replaced at least once 
every day. "With proper precaution, there is no fear 
of either cold or fatigue being caused by so doing. 
All inconvenience is the more readily avoided if the 
shirt or gown of the child be made in a form admit- 
ting of easy adjustment and removal. 

The care of the hair of the sick child demands atten- 
tion. The hair should not be left uncombed, to form a 
matted cap impregnated with sweat, and exhaling an 
offensive odor. Neither is it an appropriate time to 



398 THE NURSING OF CHILDREN. 

make an elegant artistic arrangement of the hair. 
But the head ought to be combed daily, in order that 
the air may circulate there, and that the scalp may 
be kept cool and clean. 



THE BED AND BEDDING- OF THE SICK CHILD. 

Free passage around the bed of a child is necessary 
for its proper care, and the proper circulation of air. 
For this reason, the placing of the bedstead in an 
alcove or a corner of the room is objectionable. 

Feather beds, so detestable for adults, are still more 
so for children, and especially sick children. Their 
slight power of conducting heat renders them oppres- 
sive, and they are readily impregnated with the exha- 
lations from the body. 

Care must be taken not to overwhelm the child with 
too great a weight of bedclothes. Too many cover- 
ings on the bed increase the fever, sometimes provoke 
delirium, excite excessive sweating, and keep the body 
surrounded by an impure atmosphere. The child 
should be kept properly warm by attention to the 
temperature of the room, and not by heaping blankets 
and coverlets on the bed. 

It is important to change frequently the position of 
the bedridden child. It should be placed now on one 
side, soon on the other, then for a while supported in 
a half-sitting posture by the aid of the bolster, and 
in no case be permitted to remain too long in the 
horizontal position. The attitude of lying prostrate 



TWO BEDS BETTER THAN ONE. 399 

interferes with the free circulation of the blood, and 
leads to an engorgement, perhaps inflammation, of the 
lungs. Mothers ought to know, therefore, and re- 
member that (excepting in certain stages of those few 
diseases in which this is expressly forbidden by the 
physician) it is of the greatest moment to raise the 
child from time to time, and carry it about in the 
arms, or, at least, alter its position in the bed. There 
are few diseases in which this practice cannot be 
repeated with the greatest advantage three or four 
times a day. 

The iron bedstead is better than one of wood, as it 
affords a free circulation to the air, and does not absorb 
damp. 

"We have just recommended, in speaking of the 
chamber of the sick child, that two communicating 
rooms be secured if possible, in order that one may 
be thoroughly ventilated while the patient occupies 
the other. "We now also advise two beds. The little 
patient should pass one-half the day in one, the other 
twelve hours in the second bed. ~No sheets or cover- 
ings are to be carried from one bed to the other. The 
vacant bed and its coverings are to be thoroughly aired. 
This change from bed to bed is most favorable to 
cleanliness, and will be found to add greatly to comfort, 
and to materially aid in inviting refreshing sleep. 

IV. The Food and Drinks of the Sick Child. 

During sickness, particularly of young children, 
drinks constitute the principal nourishment taken. 



400 THE NURSING OF CHILDREN. 

Their nature, frequency of administration, temperature, 
etc. are all matters demanding attention. 



THE AMOUNT OF THE DRINKS. 

Children suffering with a fever naturally desire cold 
drinks. There is no harm in allaying the burning 
thirst with cold water, and no necessity of forcing upon 
them lukewarm toast or barley-water. The quantity 
given at a time should be small, not more than a 
couple of tablespoonfuls, but it may be quite cold. 
The drink ought to be offered only in a very small cup 
or glass. If the child empty this, it will be quite satis- 
fied for a time, while it would be very discontent if 
permitted to but half empty even a very large tumbler. 

It is only prejudice — which we are glad to notice is 
passing away — which would deny the little sufferer 
from fever or cough the refreshing drafts of cold 
water for which it longs. It may be allowed almost 
as often as asked for, if given in the manner and 
amount we have mentioned. Thirst has been called 
the " cross of the unhappy sick." This cross, so hard 
to bear, may be much lightened, without injury to the 
patient, by intelligent management. 

When the stomach is in a very irritable condition, 
the quantity of milk or other fluid food swallowed at 
one time should be small, but frequently repeated. In 
this manner a considerable amount of nourishment 
may be taken during the twenty-four hours, and re- 
tained by a delicate stomach. 



TO PREPARE DIET-DRINKS. 



401 



THE TEMPERATURE OF THE DRINKS 

Has a marked influence upon the system. Every one 
knows that hot drinks act upon the skin and excite 
perspiration; that warm drinks tend to induce sick- 
ness at the stomach, and thus indirectly to make the 
skin moist; and that cold drinks increase the action 
of the kidneys. 

"When it is desirable to make the skin moist, it is 
well to give the child some warm diet-drink (one of 
those we are about to describe), and every quarter of 
an hour about a tablespoonful of water in a tiny cup. 
When, however, there is no urgent necessity of pro- 
ducing perspiration, the child's thirst may be satisfied 
by offering it cold w^ater altogether, but always in the 
little glass of which we have spoken, so that too 
much may not be taken into the stomach at one 
draft. 

DIET-DRINKS. 



The number of diet-drinks is very great. They 
have a high reputation in domestic practice. The 
French have a much larger variety (under the name 
of tisanes) than we. Many of their preparations 
deserve to be better known here. 

Barley -ivater. — This has been described as the most 
classic of the diet-drinks, it having been recom- 
mended by Hippocrates himself, the great Father of 
Medicine, in the fifth century before Christ. It is a 
useful drink in all feverish conditions, particularly in 

26 



402 THE NURSING OF CHILDREN. 

inflammations of the lungs, bowels, or kidneys. 
"When there is diarrhoea, it is to be preferred to 
rice-water, having a more soothing action upon the 
bowels. 

In preparing barley-water, pearl barley should be 
chosen. 



Take of— 

Well-washed Pearl Barley, two ounces ; and boil it 

for a short time in half a pint of water. 
Throw away the water from the barley, and add two 
quarts of boiling water. 
Boil the whole down to a quart, and strain. 



In cases of catarrh in the chest, a very useful and 
agreeable preparation, which is soothing to the cough 
and slightly laxative in its effects on the bowels, may 
be had by adding to the quart of barley-water, made 
in the above-described manner, two ounces and a half 
of figs, five drachms of bruised liquorice-root, two 
ounces and a half of stoned raisins, and a pint of 
water. Boil the whole down to a quart, and strain. 

Or, instead of this compound barley-water, the 
simple barley-water may be sweetened, in cases of 
cough, with a little honey. 

Oatmeal Gruel, — This is a nourishing and agreea- 
ble dietetic preparation. It acts slightly both upon 
the bowels and kidneys. Although so frequently used 
in the sick-room, it is often improperly prepared. It 
may be made as follows : — 





TO MAKE OATMEAL GBUEL. 


403 




Take of— 

Oatmeal, two tablespoonsful. 

Cold water, one teacupful. Mix, and allow to stand 
for a few minutes until the meal swells. 

Boiling water, one pint. 
Throw in this boiling water the paste of meal made 

with the cold water, and boil for an hour, stirring 

occasionally. Then sweeten, and add a few stoned 

raisins and a little nutmeg. 




A still more nutritious preparation may be made by 
using milk instead of water. 

Rice-water. — This preparation has had, from time 
immemorial, a reputation in affections attended with 
looseness of the bowels. To make it, proceed as 
follows : — 




Take two tablespoonsful of Rice, and boil in a quart 
of water for an hour and a half. Then sweeten and 
flavor to suit the case. 






Toast Water. 






Take some Toast, made as brown as it can be without 
burning. Put it in a bowl, and pour cold water over 
it. Sweeten. 




Sou 
cold, 
tamari 
gratef 
tive. 

Mil 
others 
necess 


r Drinks. — These drinks are generally 
The most usual are lemonade, orangead 
md water. The last in particular forms 
ul drink when there is fever; it is slight^ 

h. — This drink has the great advantage o 

in the fact that it alone contains all t 

ary to support life; it can, even if no othe 


taken 
e, and 
a very 
t laxa- 

s^er all 
hat is 
r food 



404 THE NURSING OF CHILDREN". 

be taken, supply all the needs of the system for 
repairing waste and building up tissue. Moreover, it 
thus completely nourishes the body without fatiguing 
the stomach or exciting the nervous system, an 
advantage of great moment in feverish conditions. 
Its use, pure or diluted with water, or mixed with 
other drinks, is indispensable in the diet of a sick 
child. 

Tea ought to be banished from the table of young 
children, sick or well. Their nervous system is too 
prominent and excitable to permit of the use of drinks 
of this character without more or less injury. The 
same remark may be made with reference to coffee. 

DIETETIC PREPARATIONS FOR THE SICK CHILD. 

Arrowroot Pap. — This is an excellent dietetic prepa- 
ration in all febrile complaints, and in disorders of the 
stomach and bowels. It is best made in the following 
manner: — 




Mix a heaping tablespoonful of Arrowroot with suffi- 
cient cold water to make a paste. Gradually add to 
this paste a pint of boiling water, stirring it well all 
the time. Keep the mixture on the fire for five min- 
utes. 






Arrowroot Pap with Milk. 






Mix a dessertspoonful of Arrowroot to a smooth 
paste in a little cold Milk ; place a pint of Milk on the 
fire to boil ; as soon as it boils, stir in the mixture of 
arrowroot and milk ; keep the whole on the fire for five 
or ten minutes, stirring it constantly; then flavor to 
please the patient. 











TAPIOCA, SAGO, AND PANADA. 405 

This preparation is more nourishing than arrowroot 
pap made with water, but in some cases the latter is 
preferable. 

Tapioca. 



Place a teaspoonful of Tapioca in a teacupful of cold 
water, and allow it to soak during the night. Then 
add a pint of water or milk, and a little salt. Put the 
mixture on the fire to simmer, and stir well, after its 
removal, while cooling. Sugar and nutmeg, etc. may- 
be used to render it more palatable. 



Sago. — This substance is usually better liked than 
arrowroot or tapioca, and it is more readily digested 
than rice. It is useful during recovery from an ill- 
ness, and for a time advantageously takes the place of 
food richer but more apt to disagree. 



Take a tablespoonful of Sago, and boil it for a long 
time in a pint of water. Take great care that all the 
grains be dissolved, and always strain the mixture. 
Nutmeg or some other spice may be used to season 
with, if not forbidden by the medical attendant. 



Panada. 



Stale Bread, cut half an inch thick, and free from 
crust, is to be toasted to a nice brown. Two slices of 
this toasted bread, cut into small squares, are to be 
placed in a bowl, and a little salt sprinkled on them. 
Then a pint of boiling water is to be poured on, and a 
little nutmeg grated over the surface. 



Of course it is important, in making all these prepa- 
rations, that they be not scorched. To guard against 
this, a double boiler is to be preferred. A double 



406 THE NURSING OF CHILDREN. 

boiler can be made at once by placing a pitcher in a 
large kettle of boiling water. 

Pap of Unbolted Flour. 



Take a tablespoonful of Unbolted Flour, and mix it 
with sufficient cold water to make the thickness of cream. 
Stir into this a pint of boiling water, and simmer until 
it becomes entirely clear. Add a little salt, and, after 
stirring and beating it well, remove it from the fire. 
Then mix with four tablespoonsful of Cream, and 
sweeten with white sugar. 



The pap may be eaten with cream, and made thicker 
if preferred. 

Pap of Boiled Flour. 



Take a teacupful of Flour, tie it up tightly in a cloth, 
and boil for six hours. Cut off and throw away the 
outer soft, doughy portion of the ball. Grate the hard 
portion, and mix with cold Milk to the thickness of 
thin starch ; then stir it into boiling milk, and sweeten 
with loaf sugar. 



Gelatine Food. — The following preparation is one 
which has been long recommended by Dr. J. Forsyth 
Meigs, and which will be found to serve an excellent 
purpose in cases of sickness, as well as to make an 
admirable food for children brought up by the hand, 
or recently weaned. With a little care, it can readily 
be made, by any one acquainted with cooking, in a 
palatable form. 



PREPARATIONS OF ARROWROOT. 



407 



Take a piece, two inches square, of Gelatine, soak it 
in cold water for a short time, and then boil it in half 
a pint of water until it is dissolved, which will be in 
about ten or fifteen minutes. Have at hand a tea- 
spoonful of Arrowroot, mixed into a paste with a little 
water, and add it to the boiling water, before removal 
from the fire, with a half tumbler of Milk, stirring the 
whole constantly. Then pour in one or two tablespoons- 
ful of cream. Sweeten with a moderate quantity of 
loaf sugar, and, at once, take from over the fire. (If 
left over the fire, with the sugar in, it will burn. ) 



Dr. MereVs Food for Children. — The following direc- 
tion for making a food suitable for feeble children with 
disordered bowels will also be found of great value: — 



Take a teaspoonful of Arrowroot, and boil it in three- 
quarters of a pint of water. Mix this with one-quarter 
of a pint of slightly boiled Milk, and add one or two 
tablespoonsful of cream. 



The above quantity represents one day's supply. 
Children digest well this amount, or half as much 
again, according to their age. As they get older, Dr. 
M. increases the proportion of the milk, but not of the 
cream. 

Another excellent preparation of arrowroot is made 
as follows : — 



Place a teaspoonful of Arrowroot into a porcelain 
vessel, with as much cold water as will make it into a 
fine dough. Then add a cupful of boiling milk, or of 
beef -tea, stir the mixture a little, and allow it to boil 
for a few minutes, until the whole acquires the consist- 
ency of a fine jelly. 



408 THE NURSING OF CHILDREN. 

Prof. Liebig^s Soup is an admirable food for chil- 
dren, sick or well. It is made in the following 
manner : — 



Take a heaped tablespoonful of Wheat Flour, a table- 
Spoonful, not quite so heaped, of Malt Meal, and seven 
and one-half grains of Bicarbonate of Potash. (The 
bicarbonate of potash may be obtained from the drug- 
gist, put up in powders of seven and one-half grains 
each, ready for use. ) Mix the wheat flour, malt flour, 
and bicarbonate of potash well together ; then add two 
tablespoonsful of water, and again mix, and finally mix 
with ten tablespoonsful of milk. Place the mixture 
upon a slow fire, and stir it constantly until it begins 
to get thick. At this period, remove the vessel from 
the fire, and stir the mixture for five minutes, heat it 
again until it gets thick, then remove and stir it until 
it becomes quite fluid, and finally heat it until it boils. 
The soup is purified from bran by passing it through a 
fine sieve (a piece of fine linen), and now it is ready 
for use. 



The barley-malt required is to be had at any 
brewery. It mnst be freed from impurities, and then 
ground to a coarse meal in an ordinary coffee-mill. 
The wheat flour employed should be the common fresh 
wheat flour, and not the finest, for the latter is not so 
rich in starchy matter. 

This soup is as sweet as milk, and, after boiling, 
may be kept for twenty-four hours without under- 
going any change. It is slightly laxative in its 
effects upon the bowels. "When there is a tendency 
to diarrhoea, instead of using the seven and a half 
grains of bicarbonate of potash, substitute twenty 
grains of prepared chalk in making the soup. 

Children will frequently take raw meat, simply 
minced, when they are suffering from great debility. 



RAW MEAT DIET. 409 

One teaspoonful of such meat may be given every 
four hours. 

In prostrated cases of cholera infantum, the raw 
meat diet, prepared as recommended by the distin- 
guished French physician, Prof. Trousseau, will be 
often seized with avidity by children and well borne. 



Lean Beef or Mutton is first finely hashed, pounded 
in a mortar to a pulp, and then passed through a fine 
sieve. The thick concentrated juice thus obtained is 
nutritious and digestible, and, when salted or other- 
wise flavored, quite acceptable. Give one or two table- 
spoonsful in fractional doses the first day. If well borne 
by the stomach, increase the quantity day by day, until 
a quarter or half a pound is taken in the course of the 
twenty-four hours. For the first day or two, much of 
it may pass, hardly changed, from the bowels ; but this 
alone should not occasion its discontinuance. 



White of eggs thinned with natural or artificial 
Seltzer-water, or with weak lime-water, make an ex- 
cellent drink in the summer bowel complaints of 
children. 

For other dietetic preparations, see article on 
"Cookery for the Sick" (for page, look in Index). 

In the case of the sick infant before the period of 
weaning, the best food it can have is that from the 
mother's breast, to which it should be confined alone 
during its illness, provided a sufficient amount of 
nourishment can be found there. The child will often 
seek to nurse when it is merely thirsty from the effects 
of fever. The danger of overloading the stomach in 
this way may be avoided by frequently giving it a 
small amount of cold water in a glass to drink. 



410 THE NURSING OP CHILDREN. 



ATTENTION TO GIVING FOOD. 

In all cases of infantile disease, it is of the utmost 
moment that the child should be supported by proper 
nourishment. This requires attention to the giving 
of food on the part of the nurse. In many exhaustive 
affections, when the little patient is greatly reduced in 
strength, the desire for food ceases, or the power of 
expressing that desire is gone. The child sinks into 
a doze, and will pass hours without consciousness, 
and, of course, without making known the wants of 
its system for food. In these instances, if the child 
be not offered food because it does not seek it, or if 
food be withdrawn because it is not eagerly taken, the 
patient will become weaker and weaker, and finally 
pass into a condition beyond the reach of either food 
or medicine. It should be remembered that the life 
of the little one depends upon its having a proper 
quantity of nourishment. When the attending physi- 
cian directs a certain quantity to be given at certain 
intervals, these directions should be scrupulously fol- 
lowed, a dereliction in duty may be fatal. Often the 
kindly perseverance and tender watchfulness of the 
nurse will be severely tried ; for, in the fretfulness of 
sickness, the child will refuse at one moment what it 
will take readily almost the next. In very serious 
illnesses, when the child is much exhausted, a strict 
account should be kept on paper of the exact amount 
of food and drink given, and of the time of adminis- 
tration. Injudicious forcing of food upon the child in 
cases of fever may be productive of injury, as we shall 



THE DANGER OF FORCED FEEDING. 411 

presently point out. In most diseases, however, the 
greatest danger is to be feared from the neglect of the 
mother to rightly support the flagging powers of the 
sick child by properly prepared and properly given 
food. 



THE QUANTITY OF FOOD AND THE NUMBER OF MEALS. 

A most important part of the treatment of a sick 
child consists in the regulation of the hour and the 
number of its repasts, the choice of its food, the way 
of preparing the articles of diet so as to make them 
most inviting to the palate and digestible by the 
stomach, the nature and amount of the condiments 
employed to season them, etc. There are many popu- 
lar errors on these points, some of which we shall 
mention. 

The amount of nourishment proper for a child 
during a fever is a subject of constant remark and 
prejudice. It is thought that all the child needs to 
strengthen it is food. The little sufferer for days has 
taken but a small quantity of barley-water or arrow- 
root, it is getting weaker and weaker, and the friends 
say "this is not surprising, for it eats nothing." 
Unfortunately the child requires something more than 
food, and the attempt to strengthen it by forced feeding 
only strengthens the disease. When there is much 
fever, food taken into the stomach is not digested, and 
therefore does harm, and may, if injudiciously adminis- 
tered, destroy the last faint chance of recovery. The 
directions of the attending physician in this regard 



412 THE NURSING OF CHILDREN. 

must therefore be scrupulously followed, for his skilled 
experience is required to determine the amount and 
nature of the nourishment needed. It is the part of 
the nurse to be implicitly obedient and to give only 
that kind and quantity of food which the doctor has 
ordered. 



V. The Care of a Child recovering from 

Sickness. 

The little patient, we will suppose, has happily 
passed through the severity of the attack of disease, 
and is pronounced by the family physician to be out 
of immediate danger. The anxiety of the mother is 
quieted, yet she must not imagine that the battle is 
entirely gained. There are yet a number of risks to 
which her charge is exposed, before health can be com- 
pletely restored. Two of these are particularly to be 
kept in view and guarded against: one is the danger 
of relapse; the other, the possibility of the disease 
fixing itself in some way upon the constitution and 
becoming chronic. Neither the mother nor the doctor 
can therefore now rest from labor; on the contrary, 
both should redouble their watchfulness and activity. 

NEGLECT OF THE CONVALESCENT. 

The sick are better cared for than the convalescents. 
During the stage of recovery, the physician, pressed by 
other and more critical cases, is too often apt to neglect 
that close surveillance over the little patient, whom he 



THE CARE OF THE CONVALESCENT. 413 

believes on the high-road to recovery, which ought ever 
to be exercised. The mother relaxes her attention 
because she is not aware of the extreme importance of 
careful scrutiny and skilful nursing to the welfare of 
the child during this the waning period of the disease. 
The time the child should be confined to the bed and 
to the room, the diet, and the amusements, are all 
matters of moment, in regard to which we have a few 
words of counsel. 



PERIOD OF CONFINEMENT TO THE BED AND ROOM. 

The tendency in most families is to keep the conva- 
lescent child too long in bed, and to confine it after- 
wards too long to the sick-room. It is difficult to 
convince them that such confinement is useless, if it be 
not hurtful, in many cases. Undoubtedly during the 
continuance of fever, when complete repose is required, 
the bed is a necessity. But it is well to raise the 
child early during the stage of recovery. The wishes 
it expresses on this subject, and its incessant motions 
in bed, are signs that it may be safely emancipated 
from the irksome embrace of the bedclothes. The 
child should of course only be kept up a short time the 
first day, and the manner in which it bears the change 
be noted as a guide for the future. If the child be 
very young, it is well to rest it upon some cushions or 
on the carpet, when it will quickly be noticed whether 
it enjoys and is benefited by the motion of its limbs. 
Prolonged confinement to the bed is injurious in 
various ways; the breathing is interfered with by the 



414 THE NURSING OF CHILDREN. 

pressure on the chest, the appetite languishes, and the 
bowels become constipated. It is well to bear these 
facts in mind when recovery sets in. 

Prolonged confinement to the atmosphere of the 
sick-room retards recovery in many instances. It is 
very difficult to say exactly how soon the child should 
be taken into the outer air, the time depends upon the 
nature of the disease, the climate, and the season. 
Catarrhal and rheumatic affections require special 
precautions in this respect. The same is also true of 
scarlet fever and measles. 

In scarlet fever particularly it is necessary to keep 
the little one in the quarantine of its room for a con- 
siderable time. The saddest consequences in the shape 
of convulsions and dropsy may, and often do, result 
during recovery from this disease, when children are 
exposed prematurely to the outer air, especially in a 
northern climate, and the cold season of the year. 
The child ought always to be confined to the room 
until after the twenty-first day, no matter how mild 
may have been the attack. During cold weather, it 
should not be permitted to leave the house under forty 
days. Dropsy is a common and very fatal attendant 
upon scarlet fever. The exciting cause is premature 
exposure to cold and moisture. If the patient be not 
allowed to run about the house, where there is constant 
danger from the drafts through open windows and 
doors, nor taken to walk or ride in the outer air until 
after the twenty-first, or, in cold weather, the fortieth 
day, it will escape this dangerous implication. 

Measles do not require a sojourn so prolonged in the 



THE CONVALESCENT CHILD OUT OF DOORS. 415 

chamber. The troubles which follow this disease ar.e, 
with the exception of injuries to the eyes and ears, all 
located in the bronchial tubes and lungs. The condi- 
tion of the breathing apparatus should, therefore, be 
carefully watched, and the child protected from colds. 
When, however, all symptoms of catarrh have disap- 
peared, the child may be taken out on the twentieth 
day, provided the weather is favorable. 

The passage of the child from the sick-room to the 
street should be a gradual one, not the event of a day. 
It ought first to be taken from one room in the house 
to the other, the rooms being alternately well aired, so 
that it may be gently accustomed to a change of air ; 
then a short carriage-ride can be ventured on; the 
clothing must be warm, and only by degrees lessened 
in quantity as the child becomes familiar with the 
outer air ; the walks or rides should be varied in direc- 
tion in accordance with the daily wind, the shade, etc., 
and slowly increased in duration. All these precau- 
tions are important, but unfortunately often overlooked. 

THE DIET OF THE CHILD DURING RECOVERY. 

We have spoken at some length of the food and 
drinks required by the child during the attack of sick- 
ness; now we have a few suggestions to offer as to the 
diet required during recovery. This differs from the 
ordinary food of a well child only in its extreme sim- 
plicity and in the smallness of the quantities which 
are allowed at one time. 

Cookery for convalescent children is not that of 



416 



THE NtTRSINGT OF CHILDREN. 



those who are in health. It has nothing to do with 
that complexity and profusion of dishes which appear 
on our tables, to excite the appetite of the palate when 
that of the stomach has been satisfied, and to impose 
upon the stomach a task in analysis of which it is 
barely capable, good chemist as it is. The digestive 
powers of the little patient are fatigued by the trials 
through which it has passed; only food, therefore, 
simple in character and preparation should be per- 
mitted. All pastry and rich sauces are improper. 

We will pass in rapid review some of the principal 
articles of food to which the preference should be 
given. First of all, tread, well cooked and sufficiently 
stale, pleases children, and affords useful exercise in 
mastication and digestible nutriment. It is much 
better than sweet cake, which often disagrees. 

Eggs, fish, meat, the simpler vegetables, and ripe 
fruit constitute the bill of fare first to be allowed. 
But the value, nay, the safety of these articles, depends 
much npon the manner in which they are prepared. 

Eggs make a happy transition from the paps and 
broths to solid food. The eggs must be entirely 
fresh, however; if at all stale, they will provoke indi- 
gestion. The greatest care must, therefore, be taken 
to get only those which are newly laid. Let the egg 
he an hour old, the oread a day. 

The egg is best when soft-boiled. Place it for two 
minutes in boiling water, and keep it two minutes 
more in the same water (removed from the fire) at a 
temperature a little below the boiling point. Thus 
cooked, the egg makes an excellent and readily di- 



THE DIET OF CONVALESCENCE. 417 

gested food ; all other methods of cooking it are infe- 
rior to this, as they harden more or less the white, and 
render it therefore less easy of digestion. 

The flesh offish affords an excellent article for the 
table of the convalescent. Here also it is absolutely 
necessary that there be not the least suspicion of a 
want of freshness. Oysters, during the proper season, 
are very useful, particularly when panned or roasted. 

The white meats, chicken and veal, and the dark, 
beef and mutton, are most nutritious when broiled or 
roasted; the white meats should be well cooked, the 
dark be somewhat rare. 

Among the vegetables, the potato, endive, spinage, 
and asparagus furnish an agreeable and healthful va- 
riety for the table of the convalescing child. 

Stewed apples, pears, and prunes are articles of 
which the usefulness has been confirmed by long expe- 
rience. In season, fresh fruit is very grateful and 
harmless. There is a popular dread of fruit as a cause 
of disease and death to children in the summer season, 
which is without foundation. Dr. Snow, the well- 
known Health Officer of Providence, Rhode Island, 
has shown the error of this view. Nearly all the mor- 
tality from summer complaints is among children too 
young to eat fruit and vegetables. The impure air 
which is breathed by children in the cities during the 
heated term, is a far more potent cause of sickness 
than the food that is eaten. Let the little ones, there- 
fore, eat freely of fresh ripe fruits. 



27 



418 THE NURSING OF CHILDREN. 

EXERCISE DURING CONVALESCENCE. 

The child should return by slow steps to its ordinary 
daily exercise. A moderate daily exertion in walk- 
ing, and active play, proportioned in amount to the 
strength, augments the physical powers and hastens 
their restoration to full vigor ; exercise carried beyond 
this point exhausts them and retards recovery. Mode- 
rated exercise induces sleep, that which is exhaustive 
and injudicious produces sleeplessness and a condition 
of nervous excitement. 

The heart of a child which has just passed through 
a long sickness is singularly excitable; it beats with 
more force and quickness. Too much fatigue at this 
period may lead easily to disease of the heart. The 
danger is particularly great when the period of conva- 
lescence coincides, as is often the case, with a rapid 
growth, for at this time the heart is peculiarly sus- 
ceptible. 

Passive exercise in the carriage, walking with slow 
steps, certain games in which a measured movement 
is united with an active sense of pleasure, all admit 
of graduation. If the child becomes pale, if it is 
covered with perspiration, if dark circles form around 
its eyes, and if it returns to its bed prostrated, it is 
evident that the proper limits have been passed, and 
that it is necessary to retrace the steps. 

Convalescence is a sort of second creation. The 
functions show themselves timid, the organs present a 
new delicacy of structure, ordinary influences fatigue 
or completely exhaust them. This condition of the 



MAKE HASTE SLOWLY. 



419 



body in all its parts calls for constant care. Repose 
is the first and the most imperative need of the system 
at this time. 

After a severe illness it is better, if it be possible, 
for the city child to be carried into the country as 
soon as its condition will permit. There recovery will 
be more rapid and complete than it can be within the 
limits of a great city. 

WHEN TO RETURN" TO SCHOOL. 

Finally comes the grave question, how soon the 
child may resume its school studies. The same pre- 
cautions here are necessary that we have pointed out 
in connection with the resumption of the ordinary diet 
and exercise. Haste must be made slowly. A brain 
fatigued by a long illness must be rested for a long 
time. The restoration of the general health indicates 
only that the mind may have recovered its aptness ; the 
memory has often received a blow that it needs several 
months to recover from. Above all, after an attack 
of typhoid fever a long mental rest is obligatory. 
There is not a physician of experience who cannot 
remember instances of the saddest results from a too 
early return to school after recovery from this fever. 






■ ,:..-- ^ ...... ■ ■_... ■ . : , ' 

i ■ 





CHAPTER IL 

THE NURSING OF ADULTS. 

Section I. The Sick-Room. The structure of the sick-room — The furni- 
ture of the sick-room : Bedstead ; Thermometer ; Feeder ; Medicine- 
spoon ; Medicine-glass ; Sick-tray ; Lamp and saucepan ; Nursery lamp ; 
Stomach- warmer ; Foot-warmer ; Air and water cushions ; Clothes cradle ; 
Bedside pocket ; Wicker baskets ; Funnels ; Porringer ; Oiled-silk ; 
Bandages ; Sponges ; Hand-bell ; Bed-chair ; Invalid-lifter ; Invalid-wrap ; 
The bed and bedding — The warming of the sick-room — The ventilation of 
the sick-room : The relation of atmospheric purity to temperature ; An 
important hint— The light of the sick-room — Cleanliness of the sick-room 
— Twenty-four hours in the sick-room — Management in the sick-room 
— The petty cares and needs of the sick-room. 

Section II. The Person op the Patient. The care of the skin — The 
sponge bath — Acid sponging — Salt-water sponging — The warm bath — The 
hot bath — The cold bath — Local baths : The foot bath ; Acid foot bath ; 
The hip bath; The shallow bath — The dripping sheet — Cold affusion — 
The douche bath — Wet sheet packing — The wet compress — The plunge 
bath — Medicated baths : Sulphur bath ; Compound Sulphur bath ; Alka- 
line bath ; Acid baths ; Iodine bath ; Borax bath ; Creasote bath ; Hem- 
lock and starch bath ; Artificial sea-water baths — The Turkish bath — The 
shower bath — The vapor bath — The dry heat air bath — The nurse's hands ; 
How to clean them — The clothing of the patient — Exercise and sleep — 
How to secure sleep to the patient — To change the sheets under the sick — 
To change the clothing of the sick — To move the patient in bed — To carry 
the patient. 




U" the chapter just closed, we have confined 
ourselves quite closely to the directions in 
nursing which apply more particularly to the sick- 

( 420 ) 



THE APAETMENT OF THE SICK. 421 

ness of children. We have now before us, in the pre- 
sent chapter, the task of making plain to our readers 
the manner of properly managing the chamber and 
person of the adult sick intrusted to their charge. 
Convinced of the importance of the theme, we shall 
be minute, even to a fault, in our counsels. 

I. The Sick-Room. 

Every man who builds for himself a house should 
in its construction bear in mind the certainty that he 
and those dearest to him will at some time be afflicted 
with sickness or suffer from accidents. He ought, 
therefore, to provide for this contingency by con- 
structing a room especially designed for "the sick- 
room." Such a room may be furnished and used as 
an ordinary bedroom so long as it is happily not 
needed by the sick. 

This suggestion will be found a useful one. We 
will give some details of the best methods of carrying 
it out, and also of so arranging an ordinary room in a 
house already built that it may be most healthful and 
pleasant for the invalid. 

the structure of the room. 

The larger the sick-room the better, provided the 
conveniences at command for warming and cleanli- 
ness are in proportion to its size. The ceilings and 
walls should be of a light or neutral tint, without 
figures or patterns. Bright and grotesque outlines 



422 THE NURSING OF ADULTS. 

on wall and ceiling papers often, in nervous and 
febrile disorders, excite the fears or the curiosity of 
the patient and prevent sleep. It is better not to 
have walls papered at all. If papered, the paper 
should be glazed. Plaster is very little, if at all, 
better than paper. The best wall is that painted in 
oil. This admits of washing, and therefore of the re- 
moval of all the animal exhalations which collect on it. 

The sashes of the windows should be tightly fitted, 
so that they will not rattle in the wind, and should 
open both from above and below, in order to permit 
of proper ventilation. It is well to have inside 
shutters, in order to better arrange the light. Both 
the shutters and the sash must have secure fastenings. 
It is preferable to have a removable key with which, if 
required, to close the fastenings, for, in some diseases 
of the brain, and during the delirium of fever, the 
patient may attempt to spring from the window in the 
temporary absence or sleep of the attendant. The 
windows should look out upon, when possible, a plea- 
sant prospect, a garden or green fields. Shades are 
to be preferred to curtains. 

The fireplace ought to be an open one. An open 
fire is the best ventilator yet devised. The chimney- 
shaft should be in the middle of a wall, and built high 
and wide. The current of air through the fireplace 
up the chimney carries off the products of combustion 
and breathing, and, in order to secure perfect ventila- 
tion of the room, it is only necessary to provide for 
the entrance of air from without. This may be accom- 
plished by ventilators over the door or over the win- 



OPENINGS FOR VENTILATION. 423 

dows, or by carrying up an air-shaft in the brick- 
work by the side of the chimney, or by running up 
an air-flue or tube of iron or zinc inside the chimney, 
with the opening near the floor, for it is better to have 
the fresh air enter near the bottom of the room. The 
grate should be of a good size and rather low, and no 
barrier be permitted to check the free passage of the 
air up the chimney. 

The door of the sick-room ought to be a heavy one 
(not less than two inches thick), and hung securely, 
so that it will open and close as noiselessly as possible. 
A second or dumb door of baize, made to swing in the 
opposite direction, will be found useful in excluding 
noise. A ventilator is to be constructed over the 
door, or, what is better, openings fitted with slides, 
placed at the side near the floor. 

"We have already spoken, when treating of the 
chamber of the sick child, of the desirability of having 
two adjoining rooms, for the convenience and comfort 
of the nurse and invalid. This arrangement is un- 
fortunately rarely possible, and all the good effects we 
claim for it can happily be secured by that proper at- 
tention to the ventilation and warming of the sick- 
room, the details of which we shall shortly point out. 

THE ETTRNITURE OE THE SICK-ROOM. 

It is preferable to have the sick-room furniture 
made of unpainted wood — as oak or walnut. The 
number of pieces should be as few as possible. There 
need be no wardrobe, clothes-press, or bureau, except- 



424 THE NURSING OF ADULTS. 

ing a small one. A few tables are required; a small 
one on castors, so that it can be moved to the bedside 
when wanted ; a larger and firm one for holding such 
bottles, dishes, etc., as are in immediate demand; 
and a third, if there be space, for a dressing table, 
over which may be hung a glass. Three chairs are 
sufficient, two ordinary ones, and an easy or invalid's 
chair. There should also be a lounge or inclining 
sofa. The washstand ought to be on castors, so that 
it may be placed at the side of the bed. This is of 
great convenience to the patient. The basin, bowl, 
and other articles on the washstand, are best of white 
earthenware or china. 

The bedstead ought not to be more, than three and a 
half feet wide. Iron is a better material than w^ood. By 
providing two such bedsteads, in cases of close confine- 
ment to the bed, the comfort and health of the patient 
are enhanced. Each bed should have its own sheets 
and blankets. The patient passes twelve hours in 
each, the entire bedding of the bed not occupied being 
hung up to air until it is necessary to "make" it 
again. The bedstead is to be placed at the side of the 
window, or between the two windows, with its head to 
the wall, so that it can be approached on either side. 
It should be low, in order that the patient may readily 
get in and out — an important matter. The height 
should be such that, when the patient is sitting up, 
his head should be on a level with the nurse's shoulder, 
to enable her to have full and free command of the 
person. 

iNo trunks or bandboxes should be placed under the 



ARTICLES EOR THE SICK ROOM. 425 

bed to obstruct the circulation of air, still less should 
this space be made the receptacle for dirty linen. 

A closet or cupboard is an almost necessary part of 
a sick-room. It had better be so high as to be out 
of the reach of children. In it are to be kept the 
requisite appliances and utensils in use, and, on a 
separate shelf, the medicines which are actually 
employed. 

It is desirable, for purposes of cleanliness, that the 
carpet of the sick-room, if it have any, should not 
reach to the walls, but that there should be a bare 
space around it. It is convenient to have always at 
hand a piece of oil-cloth or drugget, with which to 
cover any portion of the carpet when called for. A 
painted or polished floor, or one covered with oil-cloth 
or matting, is much better for the invalid than a car- 
pet, which collects and harbors dust and the sickly 
emanations from the body of the patient. 

The thermometer must not be forgotten. It ought 
always to be found on the wall, hung at the height 
of the bed. It should be so made that it can be thrust 
into water, in order to ascertain the temperature of a 
bath. 

The cupboard which we have described should con- 
tain a number of useful articles to aid in ministering 
to the wants of the sick. Among these are: — 

A Feeder, — This is a vessel of china or earthenware, 
the top of which is half covered. It is furnished with 
a spout and one or two handles (one for the nurse to 
hold by, and the other for the patient to guide the 
vessel with). This has many advantages over a cup 



426 THE NURSING OF ADULTS. 

in administering broths, tea, or other fluids to the 
patient, who is propped up in bed, or obliged to drink 
in a recumbent position. It prevents the liquid from 
spilling over the clothes, and is more convenient for 
the patient to drink from. 

A Medicine Spoon. — This is a covered spoon, with a 
lid in the cover and an opening near the end. The 
medicine is placed in the spoon, and. the lid closed. 
The contents are swallowed through the opening with- 
out danger of spilling any. This is a very useful con- 
trivance for giving medicine to children and to adults 
who are partially unconscious or much exhausted. 

Medicine Glass. — Instead of giving medicine in a 
spoon — an uncertain measure, as spoons vary in size 
— it would be well if every sick-room were furnished 
with a graduated glass, now readily procurable, upon 
which is marked a teaspoonful, a dessertspoonful, and 
a tablespoonful (representing exactly the eighth, the 
fourth, and the half of a fluidounce). Perfect accu- 
racy in dose is thus procured, much to the advantage 
of the patient and to the relief of the doctor, who is 
often fearful lest the spoonful of a powerful medicine 
he orders one day, or to one patient, should be given 
in a spoon containing double the quantity of that used 
for another day or another patient. 

Sick-tray. — A tray supported upon legs, and hol- 
lowed out so as to fit the body, is very useful. It is 
placed upon the bed in front of the patient, who then 
sits, as it were, at his own table. It is much prefer- 
able to an ordinary waiter placed flat on the bed, or to 
a small stand at the side of the bed. Such a tray, 








To face pA27. 



Furniture for the Sick-room, 



HOT WATER IN THE SICK-ROOM. 427 

which can easily be made by a carpenter or tinman, is 
seen in the accompanying illustration. 

A Lamp, Kettle, and Saucepan. — A small teakettle, 
with lamp and pan, will be found very convenient for 
keeping food or drink warm in summer-time, when a 
•fire is not desirable during the night. 

Hot water may readily be obtained by heating it in 
a tin cup over a gas-jet, or in a covered vessel fitted 
with a rim around the bottom in which to burn a 
little spirits of wine (alcohol.) By the use of the 
latter, water may be brought to a boiling point in a 
few minutes. 

A useful nursery or night lamp is described by 
Prof. Parrish, and seen in the accompanying illustra- 
tion. 

In this apparatus (known as Fish's nursery lamp), the heat, 
communicated from the flame to the chimney, is made avail- 
able for heating liquids, a, is a common kerosene lamp, with 
the peculiar burner necessary for the utilizing of this fuel ; 
over this is ingeniously fitted a chimney of copper, b, around 
which is a vessel, c, of tinned iron; the outer surface of the 
copper chimney, constituting the inner surface of the vessel, 
is also tinned. This tinned vessel is provided with a handle 
and spout, and an earthen vessel, shown in Fig. 3 (in section 
at g, Fig. 2), is a useful though necessarily ill-shaped appendage 
for keeping liquids warm, or for heating them below the boil- 
ing point. In Fig. 1, the apparatus is seen with a metallic 
cover, and a small casting placed over it to support a tin cup 
or other vessel to be heated. At d, in the inverted dome, 
which supports the heating vessel, is an opening filled with a 
piece of mica, through which the flame may be inspected, and 
which, in using the apparatus as a nursery lamp, serves to 
throw out sufficient light into the apartment. A further 
advantage claimed for this as a chamber or nursery lamp, is 



428 THE NURSING OF ADULTS. 

that the vessel, being filled with water, keeps, by its constant 
evaporation, the air of the room from becoming dry. 

The usefulness of this lamp for keeping a supply of hot 
water at hand, and for keeping soups, tea, or other necessary 
preparations for the sick-room in a proper condition for the 
patient, will be apparent. This apparatus was employed with 
advantage in the hospital cars, so thoroughly fitted up by the 
United States Sanitary Commission for the care of the sick 
and wounded during our late war. In using it, however, we 
would call attention to the remarks on page 146, in reference 
to the dangers attending the combustion of kerosene oil — 
better employ lard oil. 

Drinking-Glass. — An excellent drinking cup for the sick 
consists of an ordinary tumbler, placed in a circular wooden 
band, which is attached to two perpendicular bars, and can be 
made to move to and fro by the simple force of the mouth. 
A wooden plate is attached to the lower part of the drinking- 
glass to receive all waste fluid. By this simple invention, the 
difficulty connected with drinking in a horizontal position, 
and the staining of clothes by fluids contained in the glass, 
are avoided. The engraving represents the drinking-glass in 
action and at rest. It can readily be made by any one a little 
skilled in the use of tools. 

A stomach-warmer is often useful. For this purpose 
an India-rubber bag or bottle should be provided, 
which is to be filled with hot water, and applied over 
the stomach when needed. 

A foot-warmer is frequently required in sickness. 
A large bottle filled with hot water, a brick heated 
and wrapped in flannel, or a rubber cushion, or bottle 
for hot water may be used; one of these should always 
be ready for immediate wants. Earthenware bottles 
are made for this purpose, so that the feet can rest 
comfortably against the side prepared for their recep- 
tion. (See drawing.) 



PILLOW-RESTS MD SUPPORTS FOR THE BACK. 429 

The chamber ware of the sick-room should be kept 
in a commode. The "earth-closet" we have already 
described. M"o. sick-room should open directly into 
a water-closet or a conservatory. 

Curtains and heavy upholstery are receptacles for 
dust and the elements of disease. They should be 
banished from the apartment of the patient. The 
room should be made as cheerful and pretty as possi- 
ble. The pictures on the walls should be of a pleasant 
character, and the furniture grouped in such a way as 
to produce an agreeable effect. 

Billoio-Bests. — There should be in every sick-room 
two pillow-rests. They are much more convenient 
and comfortable for propping up pillows than foot- 
stools, books, rolled up coats, and other like substi- 
tutes, so frequently employed. A pillow-rest is a 
pillow made of the same width and double the length 
of an ordinary pillow, and stuffed hard with hay, 
straw, or horse-hair, or, what is still better, with oat- 
chaff, the back being six or eight inches high, and 
tapering down to a point, something like a writing- 
desk. On one or two of these the soft pillows are 
easily arranged. 

Folding Best for the Legs. — This is a simple contri- 
vance for the comfort of the patient. It keeps the legs 
raised and supported. It is made like an open book, 
to fold and unfold at will, and is covered by a pillow 
or double blanket. This secures an agreeable change 
of posture, and thus goes far to prevent the dreaded 
bed-sores. 

Support for the Back. — A small rolled pillow, about 



430 THE NURSING OF ADULTS. 

the size of the wrist, and about half a yard long, is 
extremely useful as a temporary support to the back 
or sides. 

Air and Water Cushions. — India-rubber cushions are 
made of various forms to be filled with air or water, 
warm or cold, and used to ward off pressure, afford 
support, etc. These are pictured on the annexed page. 

"No. 1 is made to contain air or cold or warm water, and to 
support any part or to be employed as a stomach or foot- 
warmer. 

No. 2 is intended, when filled with air or water, as a seat 
in cases of piles or falling of the bowel. 

"No. 3 is to be distended with air or water, and placed under 
the hip or back so as to protect these parts from pressure when 
sore from constant lying. 

Cushions made of old linen, in the shape of a ring 
and filled with bran, are useful to protect the ear or 
prominent bones from pressure. They are particularly 
needed when the patient is obliged to lie for a long 
time in one position. 

A cradle for the bed is necessary in many cases of 
wounds and injuries. It consists of three half hoops, 
fastened together, which, when placed over the limbs 
or trunk of the body, support the bedclothes and pre- 
vent them from resting upon the sensitive part. 

A hedside-pocket is convenient for fastening at the 
side of the bed to contain the patient's handkerchief, 
cologne water, or other articles he may want to use. 

Several ivicJcer-basJcets should be provided with 
divisions or compartments. One of these — a small 
one — may contain the bottles from which the patient 



ARTICLES IN THE SICK-ROOM. 431 

is daily taking medicine. They are more secure from 
injury in such a basket than on a table or shelf. All 
medicines, as soon as discontinued by the physician, 
should at once be removed from the room, to avoid the 
possibility of mistakes. As also lotions and liniments 
for external use are sometimes, by mistake, given 
internally, it is safer to have a separate basket, of a 
different shape and color, to hold the bottles contain- 
ing them. A couple of baskets for dishes, cups, and 
glasses are wanted ; one, for articles needing washing, 
to be sent away and exchanged for the other with its 
clean freight. 

Two funnels are required : one of glass for filling a 
bottle ; the other, a larger one, of tin, for filling the 
rubber cushions or stomach or foot-warmers with water. 

A porringer, graduated so as to mark the quantity 
of its contents, is useful to measure the exact amount 
of an injection given, and for other purposes. 

Oiled Silk. — A yard or two of oiled silk must 
always be kept for the purpose of covering poultices, 
etc. 

A number of bandages, made in the manner we shall 
describe in a future chapter, ought to be on hand, 
as an emergency may arise calling for their prompt 
use. 

Plaster. — A yard or more of adhesive plaster and 
some isinglass plaster should also be provided in 
advance of the necessity for their employment. 

Vinegar, mustard, Cologne water are to be kept in 
appropriate bottles. 

Sponges. — Several are needed ; a fine one for the face, 



4:32 THE NURSING OF ADULTS. 

one for the bath, and a coarse one for soaking up slops, 
etc. There is also to be a supply of castile soap. 

A small hand-hell, or gong, ought to be ready to 
place within the reach of the patient, in order that he 
may be able to summon or arouse the nurse. 

A bed-chair for supporting the weak patient in a 
sitting posture in bed is a useful contrivance. An 
ordinary chair, placed on its side so that the concave 
back may support the patient, makes, when properly 
covered with pillows, a very excellent substitute for 
the more elaborate and expensive " bed-chair." 

An Invalid's Lifter. — Feeble patients wish some- 
thing by which they can help themselves from a lying 
to a sitting posture. In many hospitals, a cord is 
fixed to a staple in the ceiling over the bed, the handle 
attached hanging within the reach of the sick person. 
This is not convenient in a private house, and a simpler 
and quite ingenious contrivance has been devised for 
the same purpose. We give a picture of it in the ac- 
companying cut. 

It may consist of a rod of wood, brass, or iron, stretching 
between the foot-posts of the bedstead, and having on it a 
hollow roller over which works a flat web, with its ends fas- 
tened to a handle, and to a broad netted or otherwise made 
shoulder sash. "When a patient, or even a stout heavy person, 
in health, for whom it is equally well adapted, wishes to rise, 
the sash is passed over the head across the shoulders, the web 
brought under the arms, and, by gently pulling the handle, 
the desired change of posture is effected. When a French 
bedstead is used, an upright strong lathe can be screwed on to 
the bedframe and fitted with a pulley or a roller like that of 
a jack-towel. Many bedsteads are constructed with a top bar 
over the footboard ; a hollow roller can be fixed to this bar. 




No. 1. 




No. 2. 



Air and Water Cushions (p. 430] 



o.3. 




To face p. 432. 



Invalid's Lifter (p. 432). 



I 1 1 ; 



THE BED OF THE PATIENT. 433 

In fact, the principle admits of an endless number of modifi- 
cations. 

In order to enable any lady who may wish to knit such a 
lifter for her own or friend's family, we will give the exact 
directions : The knitted part is large, and fits on the patient's 
shoulders and chest like a shawl. The ends of webbing, car- 
ried around the pulley, are placed within reach, so that he can 
lift himself at pleasure. To knit, set on twenty-eight stitches, 
knit seventy rows ; knit eighty rows, increasing one stitch at 
the sixth stitch of every row; then knit one hundred and 
sixty rows ; then knit eighty rows, decreasing one at the sixth 
stitch of every row ; then seventy rows, as at first. 

A Wrap for the Invalid. — An excellent over-garment 
with which to cover the shoulders and "body of the 
patient sitting in bed or leaving it for a few moments, 
is made like the Spanish poncho, as follows: Provide 
a square or somewhat oblong piece of fine flannel, 
tweed, or other woollen stuff, and cut a slit in the 
centre, long enough to pass the head through, which 
bind with ribbon or edging. For a tall person, the 
material should not be less than two yards wide by 
three long. The comfort afforded by this easy gar- 
ment is very great. 



THE BED AND BEDDING. 

The bed should not be too hard. Special attention 
must be paid to making it level. For this reason, if 
there is a sacking-bottom, it should be freshly corded 
in order to secure a level support for the bedding. 
As the under bed of straw is apt to become uneven, it 
ought to be removed, or, if not, have a fresh supply 
of straw placed in the middle. A feather or wool bed 

28 



434 THE NTJKSING OP ADULTS. 

should be gently pressed and spread evenly and 
covered with a mattress, made of horse hair overlaid 
with the best long wool. One or two blankets 
smoothly placed over the hair mattress conduce to the 
comfort of the occupant of the bed. The mattress 
should be made to fit within the bedposts, so that it 
can easily be turned daily, if possible, from side to 
side and from the head to the foot. 

The sheets and blankets should be large enough to 
admit of their being neatly and tightly tucked under 
the mattress. If they be too small, it is impossible to 
keep everything smooth and straight about the patient. 

The pillows, cases, and sheets should be frequently 
changed, especially in fevers. For the sick, they are 
best made of cotton, which does not feel so cold when 
moistened by perspiration as linen. The only bed- 
covering should be light pluffy blankets. Heavy 
counterpanes and comfortables distress the patient 
very much by their weight. 

In regard to the arrangement of pillows, Florence Nightin- 
gale makes a most judicious observation, which we feel 
obliged to quote: " Every weak patient, be his illness what it 
may, suffers more or less from difficulty in breathing. To 
take the weight of the body off the poor chest, which is 
hardly up to its work as it is, ought, therefore, to ]?e the ob- 
ject of the nurse in arranging his pillows. ISTow, what does 
she do, and what are the consequences ? She piles the pillows 
one on top of the other like a wall of bricks. The head is 
thrown upon the chest, and the shoulders are pushed forward, 
so as not to allow the lungs room to expand. The pillows, in 
fact, lean upon the patient, not the patient upon the pillows. 
It is impossible to give a rule for this, because it must vary 
with the figure of the patient ; and tall patients suffer much 
more than short ones, because of the drag of the long limbs upon 



THE GAS-GRATE. 435 

the waist. But the object is to support, with the pillows, the 
back below the breathing apparatus, to allow the shoulders 
room to fall back, and to support the head without throwing 
it forward. The suffering of dying patients is immensely in- 
creased by neglect of these points. And many an invalid, 
too weak to drag about his pillows himself, slips his book or 
anything at hand behind the lower part of his back to support 
it." 

THE WAEMIXG OF THE SICK-ROOM. 

As we have already stated, the best way of warm- 
ing a sick-room is by means of a low-down grate. 
Either soft or hard coal may be burned in it. A 
properly constructed and cared-for grate will give off 
alone sufficient heat to keep the room comfortably 
warm. For other methods of warming, and the pre- 
cautions to be observed, we refer the reader back to a 
previous chapter on the subject (see page 153). 

Ordinary illuminating gas has of late been much 
used as a fuel for heating and cooking purposes. The 
gas-grate is very handsome and convenient. A number 
of gas jets are constructed in the grate so as to play 
upon soft coal, or lumps of graphite obtained from 
the gas-works. The fire is a cheerful and hot one, 
readily kindled, increased, or diminished, and avoids 
the noise and dust attendant upon keeping up the 
usual fire. Its only disadvantage is the expense. 

The gas-stove, properly constructed (so that all the 
products of combustion are carried up a chimney by a 
strong current of air, and so that the outer case and 
jacket shall be heated only by the hot air surrounding 
the inner case, and not directly by the flame), affords a 
valuable and not expensive method of heating a room. 



436 THE NURSING OE ADULTS. 

The temperature of the room requires careful regu- 
lation by means of the thermometer. In winter as 
high a temperature cannot be borne in the sick-room 
as in summer, yet we find that the tendency is to 
make the room warmer, because the outside air is 
cooler. From 60° to 63° is ordinarily the proper tem- 
perature. In cases of consumption and other diseases 
of the respiratory organs, the temperature may be as 
high as 65° ; this is the degree of warmth at which the 
wards in the Brompton Hospital for consumption, 
London, are uniformly kept. In cases of brain and 
nervous disorders and of high fevers, particularly at 
their commencement, a cooler atmosphere is preferred, 
rarely, however, lower than 55°. 

The temperature should not be allowed to fall dur- 
ing the night, for this interferes with sleep. It is also 
to be remembered that the patient is apt to be chilly and 
cold in the morning, particularly after a restless fever- 
ish night. The warmth of the room must therefore be 
looked to in the early morning hours, and, if necessary, 
the foot- warmer prepared and comfortably adjusted. 

When the air becomes dry through the continued 
use of fire in the chamber, it may be pleasantly 
moistened by attaching some tubing to the spout of a 
boiling teakettle. The steam is readily conducted to 
any part of the room where it may be desired. In 
summer time, the hot dry air may be cooled and mois- 
tened by placing two or three hand-basins filled with 
ice-water near the open windows, or door if the outer 
air be too sultry for direct admission, so that the 
current of air may pass over them in entering the room. 



FRESH AIR FOR THE SICK-ROOM. 437 

The same object may be accomplished by keeping a 
muslin shade wet by means of a syringe. 

THE VENTILATION OF THE SICK-ROOM. 

The sick-room should be ventilated, if possible, by 
what is known as "base ventilation;" that is, the fresh 
air should enter and the impure air pass out near the 
floor. We know this is contrary to the common 
opinion, which is that ventilation is best effected at 
the top of the room, the general impression being that 
by giving near the ceiling an outlet to the heated air 
it will rise and carry off all the foul vapors. The 
incorrectness of this view has been fully demonstrated 
by repeated and extended experiments. In the wards 
of the Philadelphia Hospital under the charge of the 
Guardians of the Poor, the method of base ventila- 
tion has been tried with the most marked success. 
From the late report of the President of the Board we 
learn that all the wards in the extensive buildings of 
this institution are warmed and ventilated on the 
same general plan. The heat is admitted in all cases 
near the floor, each ward having its own independent 
hot-air chambers and flues. The flues for ventilation 
open only very near the floor and pass out at the roof, 
each ward having its own. There is no opening in 
any ventilating flue near the ceiling. To secure good 
ventilation in summer, heat is introduced into all 
needed parts of the house twice a week for two hours 
each time, and oftener if required. This warms the 
ventilating flues so that they draw all the time and the 



438 THE NURSING OF ADULTS. 

wards are kept sweet. It has been found by experience 
in this hospital that if fresh air is desired from a win- 
dow, it is better to raise the window from the bottom 
than to lower it from the top, as the latter seriously 
embarrasses the ventilation from the floor. When the 
cholera visited the insane department of the institu- 
tion, in 1866, it was the most fatal in those wards 
where there was a strong ventilation from near the 
ceiling and none from the floor; on bringing down 
the ventilation, the cholera disappeared. It is stated 
that not a single case originated or occurred, unless 
brought in, in any ward of the hospital where there 
was a thorough ventilation from the floor, or an open 
fireplace and chimney. 

To let the heat escape, some advocate ventilators 
near the ceiling or the lowering of the upper window- 
sash. This accomplishes the purpose, if the openings 
be large enough. Unfortunately, however, much of 
the pure air also passes out, and much of the foul air 
remains near the floor. When the room is too hot, the 
best way of cooling it is to check the fire in the grate 
or in the furnace in the cellar, and open the doors and 
raise the windows. The apartment will thus be cooled 
without interfering with its ventilation. 

It must be remembered that there can be no 
thorough ventilation unless fresh air, either warm or 
cold, is freely admitted. When admitted through a 
raised window or open door, the Philadelphia Hospital 
attendants find it increases the force of the ventila- 
tion, as the air in the upper part of the room still acts 
with considerable pressure upon that near the floor. 



COOL AIR KOT ALWAYS PURE. 439 

The system of heating and ventilation we have just 
described, has been productive of the happiest results 
in both the medical and surgical wards of the hospital. 
For the best methods of carrying it out in private 
dwellings, we refer our reader back to our article on 
"The Ventilation of Dwellings," on page 149. 

THE RELATION OE ATMOSPHERIC PURITY TO 
TEMPERATURE 

Pure air is not necessarily cool air, nor is cool air 
necessarily pure. Yet this is the common opinion. 
The great object of ventilation is to get the air pure 
without having it chilly. The air in the room and 
house ought to be as fresh and healthful as that out 
of doors, but not as cold in winter nor as warm in 
summer. You may make a room cool without ven- 
tilating it, and may keep a room warm with the air 
fresh and pure. 

If there is no other way of changing the air in the 
room and removing foul emanations, cover the patient 
up warm in bed, putting hot bottles to the feet if 
necessary, and then throw open all the windows and 
doors. There is no danger of his taking cold when 
properly covered in bed. There is great danger of his 
being poisoned by a foul close atmosphere. 

It has been well observed that those "nurses who make the 
greatest outcry against open windows, are those who take the 
least pains to prevent dangerous drafts. The door of the patient's 
room must sometimes stand open to allow of persons passing 
in and out, or heavy things being carried in and out. The 
careful nurse will keep the door shut, while she shuts the 



440 THE NURSING- OF ADULTS. 

windows, and then, and not before, set the door open, so that 
a patient may not be left sitting up in bed, perhaps in a profuse 
perspiration, directly in the draft between the open door and 
window. Neither, of course, should a patient, while being 
washed, or, in any way exposed, remain in the draft of an 
open window or door." 

In the case of a small room it is, of course, more 
difficult to avoid drafts than in a large one. But 
with a little forethought and management, the patient 
may be kept out of all currents of air. 



AN IMPORTANT HINT. 

It is of the utmost importance to the salubrity of 
the sick-room to remove from the neighborhood of the 
sick person, as soon as they are produced, all the ema- 
nations and secretions from his own body. Not only 
does the atmosphere of the room become charged 
with poisonous matter, but everything in contact with 
and surrounding the patient absorbs the secretions of 
his skin and lungs, through which the principal por- 
tion of the depraved matter generated in disease is 
got rid of. 

A slop-pail has no right to be in a sick-room. All 
the dishes and utensils should be washed outside, 
being carried out in a basket provided for the pur- 
pose. ,' 

Every opportunity should be taken to air the bed- 
clothes. When the patient leaves the bed only for a 
few minutes, the covers ought to be thrown back and 
exposed to the air. 

Neither wet towels, moist flannels, nor damp sheets 



LIGHT FOR THE SICK. 441 

are ever to be dried in the sick-room. Blankets and 
linen are always to be warmed and thoroughly dried 
before putting them on the bed. 



THE LIGHT OF THE SICK-ROOM. 

A light room is as necessary as a well-ventilated 
room for the sick. In our chapter on healthy dwell- 
ing-houses we spoke at some length of " light and the 
means of lighting." We need not, therefore, repeat our 
advice in this connection. There are some affections 
of the brain and nervous system, and of the eyes, in 
which a subdued light, or even a dark room, may be 
necessary for a wmile. Even in these cases, however, 
the apartment should have a southeastern exposure, 
and the light modified or excluded by blinds and 
shades. During the early and active stages of many 
diseases, a very bright light is too exciting. But in 
most affections, and always during convalescence, a 
cheerful, bright room is most beneficial. The chamber 
should not only be light, but accessible to the direct 
rays of the sun — particularly in the morning and at 
mid-day. 

A pleasant prospect from the windows enlivens and 
diverts the patient. During convalescence it is there- 
fore often desirable to move the bed so that the occu- 
pant may look out upon the sky on familiar scenes. 

In illustration of the craving frequently felt by the 
sick to see outdoors, the following case is related on 
reliable authority: A man received an injury to the 
spine from an accident, which after long confinement 



442 THE NURSING OF ADULTS. 

ended in death. He was a laborer, and had not in his 
composition a single grain of what is called "enthu- 
siasm for nature," but he was desperate to "see once 
more out of the window." His nurse actually got 
him on her back, and managed to perch him up at the 
window for an instant "to see out." The consequence 
to the poor nurse was a serious illness, which nearly 
proved fatal. The man never knew it, but a great 
many other people did. Yet the consequence in none 
of their minds, apparently, was the conviction that the 
craving for variety in the starving eye is just as 
desperate as that for food in the starving stomach, and 
tempts the famishing creature in either case to steal 
for its satisfaction. No other word will express it but 
" desperation." "And it sets the seal of ignorance and 
stupidity just as much on the attendants of the sick if 
they do not provide the sick-bed with a view, and the 
patient with variety in the objects for his contempla- 
tion, as if they did not provide the hospital with a 
kitchen." 

Recovery takes place more quickly in a room open 
to the direct rays of the sun than one from which the 
sunlight is excluded. Dr. Boswell Eeid, the ventila- 
tor of the House of Commons^ gives a marked illus- 
tration of this fact. He found, after inhaling a 
variety of poisonous gases and vapors, that he reco- 
vered more quickly from their effects when exposed 
to the full light of the sun than when he remained 
within doors in the shade. 



HOW TO SWEEP THE SICK-ROOM. 



443 



CLEANLINESS OF THE SICK-ROOM. 



The floor and walls, the bed and furniture of the 
sick-room, should all be kept scrupulously clean. 
The nurse who does not appreciate the importance of 
this statement, or w T ho has not the energy or skill to 
secure its realization, is unfit to have charge of an 
invalid. "A nurse, when told that the way in which her 
patient's room was kept was quite enough to account 
for his sleeplessness, answered, quite good-humoredly, 
that she was not at all surprised at it — as if the state 
of the room, like the state of the weather, was entirely 
out of her power. Now in wmat sense was this 
woman to be called a 'nurse?' " It is the business of 
the attendants upon the sick to see to it that dust and 
dirt be not allowed to accumulate. 

Sweeping of the room in the manner in which it is 
frequently conducted is a most disagreeable process 
to the eyes and throat of the poor sufferer. By throw- 
ing a few tea-leaves over a portion of the carpet at a 
time, and taking them up carefully with a handbrush 
and dustpan, all this may be avoided. Or, when there 
is no danger to the patient, a well-trundled wet mop may 
be gently passed over the carpet and under the bed. 
A part of the carpet may be noiselessly removed now 
and then and well shaken. A dirty carpet infects the 
air of a whole room, and renders nugatory all attempts 
at ventilation. 



444 THE NURSING OP ADULTS. 

TWENTY-FOUR HOURS IN THE SICK-ROOM. 

We will place ourselves at the side of the nurse, 
and endeavor to point out to her the principal duties 
of the twenty-four hours. 

We will commence with the morning. The first 
thing is to notice the moment the patient awakes, and 
be ready with food and drink. A little coffee, or warm 
milk, or beef-tea will often prove most grateful now. 
Before taking this, the teeth and mouth should be 
washed, and the tongue, if it be heavily coated, gently 
scraped with a "tongue-scraper," or a large spoon. 
This cleaning of the mouth will add greatly to 
comfort, and enable the patient to taste his food. If 
medicine has to be taken at this time, it should follow, 
not precede, the coffee or other drink; if administered 
upon an empty stomach, it may nauseate. The patient 
now may doze again, and, perhaps, get his first 
refreshing nap after a restless night. 

The right time for breakfast is the hour when the 
sick person is ready for it. He must not be awakened, 
for if he is asleep it is not yet breakfast-time for him, 
no matter where the hands of the clock may be. 
After breakfast the patient will probably feel suffi- 
ciently refreshed to be washed, combed, and made tidy. 
If he be very weak, he is to be sponged while lying 
down. A small soft sponge, wet in warm water, is to 
be passed gently over the face, neck, arms, and hands, 
without troubling him to make any motion or exer- 
tion. As each part is done, it is to be at once lightly 
dried with a soft, warm towel. If the patient be able 



the day's duties. 445 

to bear the fatigue, the lower extremities, especially 
the feet, are to be treated in the same manner, only 
one limb "being exposed at a time. Two or three 
minutes suffice to complete this duty, which, in a 
properly warmed room, can be performed without the 
least danger of taking cold. The temperature of the 
water may be gradually reduced as the patient gets 
better, until, finally, cold sponging be allowed. This 
daily sponging much refreshes the heated and wearied 
limbs. 

The sheets and clothing of the patient may now be 
changed, the room ventilated, and the patient left to 
himself. He may, if permitted by the physician, see, 
at this time, a member or two of his family on any 
necessary business. Food and medicine must be care- 
fully given at the hours directed. No patient should be 
long without nourishment — the less that can be taken, 
the oftener the necessity of taking it. Do not offer 
the patient the same dietetic preparation he has once 
refused. Prepare the same, or some other article, 
fresh, and serve it in as tempting a way as may be. 

In the afternoon, the invalid wants to be diverted. 
He is tired and ennuied. A few visitors, if any be 
allowed, may now be admitted. As soon as they have 
gone, bathe the temples, chafe the limbs, and endeavor 
to induce sleep. 

Again, food and medicine. Then arrange the room, 
and collect what is wanted during the night so that 
the patient may not be roused after he is ready to 
sleep. To disturb him then is to imperil his rest 
during the whole night. 



416 THE NURSING OF ADULTS. 

The principal duty when night comes is to observe 
a profound silence, and to preserve the temperature of 
the room at the same point as during the day. Let the 
nurse be careful, therefore, if the room is heated by a 
fire in it, that enough coal be brought up to last until 
morning. Place within reach of the patient a hand- 
bell, his drink, and his spit-cup if he have a cough. 

The early morning hours, from two or three to five 
or six o'clock, are the critical hours of the twenty- 
four. At this time, in cases of much exhaustion, the 
nurse should be on the alert and administer at short 
intervals the nourishment and stimulants directed. 
Neglect to support the system during these hours by 
food and drink, given at short intervals, has caused 
the death of many a patient who might otherwise 
have been tided over this period of depression and 
saved. He has passed away while the nurse has sat 
in thinking, if thinking at all, that he was in a 
"beautiful doze." 

There is no need of arousing the patient to give 
him food and medicine, unless he is very weak. 
When still strong, as at the beginning of an illness, 
his best restorative is sleep. 

Towards early morning, also, the weak patient is 
apt to get cold. If not carefully watched, the loss of 
heat may be fatal. Whenever, at this time, in ex- 
hausted conditions of the system, a tendency to chill- 
ing is observed, hot drinks should be promptly given, 
the room made warmer, and hot bottles or bricks and 
warm flannels applied to the extremities. 



THE IMPORTANCE OF FORETHOUGHT. 447 



MANAGEMENT IN THE SICK-ROOM. 

The task of managing a sick-room, of "taking 
charge" of it, is not an easy one. It requires memory, 
forethought, judgment. Yet it is the special duty of 
the nurse, who is the overseer or superintendent of 
the chamber and all that goes on within and without 
it bearing upon the welfare of its occupant, to manage 
nicely. She must not merely know how to warm and 
ventilate the room properly, but she must see that 
daily provisions are made looking thereto. She must 
not only know and perform her own duties, but also 
be able to arrange for the care of the patient by others 
during the periods, however short they may be, she is 
necessarily absent from the apartment. She should 
call to mind, before leaving the patient's bedside, what 
he may want during her absence, and see that it is 
given him ; she should think what may happen to 
him from the intrusion or carelessness of others and 
guard against the danger ; she should provide, in other 
words, for the going on of everything in her absence, 
in the same manner as though she were present. This 
can only be accomplished by thought, by /©rethought. 
An intelligent person, with a little practice in looking 
into the immediate future and noting its routine wants 
and possible contingencies, can soon acquire the tact 
of so arranging that during no moment in her absence 
shall the patient be without her protecting care, for 
she has provided for the performance of every duty by 
others while she is away. 



448 THE NURSING OF ADULTS. 



THE PETTY CARES AND NEEDS OF THE SICK-ROOM. 

There are many little matters often overlooked in the 
sick-room. One of these is, the prevention of unrea- 
sonable interruption and noise. 

It often happens that the patient who has just 
fallen asleep is rudely aroused by the abrupt entrance 
of some one into his room — some one meaning kindly, 
who did not know he was asleep. Locking the door 
is not a sufficient protection against such intrusion; 
the noise made in trying it will arouse and disturb 
the sufferer. A very simple means is always at hand, 
however, of effectually overcoming the difficulty. 
Tie a quill to the door-knob ; then, when the patient 
is asleep, or for other reasons it is desired to exclude 
others from the chamber, pass the feathery end through 
the key-hole. Everybody should be instructed to 
strictly regard this sign, and on no account try the 
handle or knock on the door when it is present. 

Loud noises are usually prohibited in the sick house. 
But trifling and annoying noises are not so carefully 
looked after. To one of these, Florence Nightingale, 
with her extreme thoughtfulness in small as well as 
great matters, forcibly calls attention as follows : — 

" I have often been surprised at the thoughtlessness resulting 
in cruelty, quite unintentionally, of friends or of doctors who 
will hold a long conversation just in the room or passage ad- 
joining to the room of the patient, who is either every moment 
expecting them to come in, or who has just seen them and 
knows they are talking about him. If he is an amiable pa- 
tient, he will try to occupy his attention elsewhere, and not 
to listen — and this makes matters worse — for the strain upon 



HURTFUL NOISES. 449 

his attention, and the effort he makes are so great that it is 
well if he is not worse for hours after. If it is a whispered 
conversation in the same room, then it is absolutely cruel ; for 
it is impossible that the patient's attention should not be in- 
voluntarily strained to hear. Walking on tiptoe, doing any- 
thing in the room very slowly, are injurious for exactly the 
same reasons. A firm, quick step, a steady, quick hand, are 
the desiderata ; not the slow, lingering, shuffling foot, the 
timid, uncertain touch. Slowness is not gentleness, though it 
is often mistaken for such ; quickness, lightness, and gentle- 
ness are quite compatible." 

Rustling of the dress, rattling of keys and of plates 
and spoons on an uncovered table, frequent and noisy 
opening and closing of doors, creaking of window- 
sashes or of shoes, hurrying and bustling movements 
about the room, speaking to the patient suddenly or 
from behind him, or at a distance, or from the outside 
of the door, or when he is walking or standing — all 
these are more or less hurtful, and therefore to be 
avoided and guarded against. 

II. The Care of the Person of the Patient. 

"We have hitherto occupied ourselves with directions 
as to the care of the room of the patient. We have 
now something to say as to his person. The bathing, 
sponging, clothing, exercise, and sleep of the invalid 
demand intelligent action on the part of his attendant. 
Like a child, he is too weak to look after his own 
wants in these respects. He stands in need of the 
motherly oversight of the nurse. 



29 



450 THE NURSING OF ADULTS. 



THE CARE OF THE SKIN". 

The skin of the patient demands our first attention. 
The proper method of sponging the patient in the 
morning we have just described. This daily sponging 
is necessary, for in sickness the action of the skin- 
glands is deranged and their secretion increased. This 
morbid secretion ought not to be allowed to remain 
in contact with the body, obstructing the attempts of 
nature to relieve herself through the skin, and giving 
off foul emanations to be inhaled to the injury of the 
system. The feeling of comfort experienced by the 
sick after the judicious cleansing of the skin is very 
great. Nor is this all. The patient is positively invig- 
orated by the removal of that which was oppressing 
the vital powers. 

We reiterate the importance of exposing only a 
small portion of the body at one time while washing. 
If this precaution be heeded and drafts avoided, there 
is no danger of any injury resulting. 

THE SPONGE-BATH. 

"When the patient gets a little strong, so that he 
can help himself, the following method of sponging 
will be found safe, pleasant, and healthful: Have a 
large basin of water of the temperature of 88° or 92°. 
As soon as the invalid rises let him remove his night- 
clothes and rub the surface of the body over with a 
soft dry towel whilst he is seated in or upon the edge 
of the bed. If he feel cold, rub until the surface 



THE SPONGE-BATH. 451 

becomes warm. Now draw on some clothing over the 
feet and legs, and proceed to sponge the neck, breast, 
and shoulders with a large sponge, or with a piece of 
flannel. Use a little soap at first until the old, hard 
scarfskin is all washed off, and a new soft one is 
formed. Then soap will be no longer necessary, and, 
in cases of great delicacy of the skin may be hurtful. 
A vast quantity of the outer skin will come away in 
the first spongings, however clean the patient may 
have thought himself. After washing off the soap 
with some fresh water, dry the skin carefully with a 
warm soft fluffy towel, and then make friction with a 
coarse Turkish towel or glove, which is preferable to 
a flesh-brush. Rub the skin well for two or three 
minutes, until every part of it becomes quite red, then 
put on the flannel shirt, which is worn next the skin. 
Next, the lower half of the body is to be proceeded 
with, the stomach, hips, legs, and feet. More rubbing 
will be useful now than was used to the first portion, 
because the circulation is slower and more feeble in 
the lower than in the upper parts of the body. After 
the use of tepid water for a few mornings, its tempera- 
ture should be lowered a degree or two each day, but 
never be cooler than 70° in summer, or 60° in winter. 
As soon as the convalescing patient is able to use 
water of this temperature he will derive benefit from 
its tonic action on the skin, and, indirectly, upon the 
respiration and digestion. 

This daily sponging soon improves the spirits and 
elevates the mind, in consequence of the effete matter 
generated in the diseased body being got quickly rid 



452 THE NURSING OF ADULTS. 

of, and the brain and nervous system, therefore, fed 
with healthier blood. Under its influence, also, the skin 
becomes softer and more permeable to the perspira- 
tion. Sponge-bathing is soothing and grateful in hot 
weather, when the patient is too weak to take a cold 
bath. It is also useful, as we shall point out when 
we come to treat of these affections, in various fevers 
and rashes. 

ACID SPONGING 

Is of value in many cases of fever and inflammation. 
Add one part of good cider vinegar to two or three 
parts of cold water, and sponge the body well with 
the mixture. The patient being weak and unable to 
move, the sponging must be done by degrees, as we 
have directed, that is, the arms, chest, and legs being 
rapidly washed in succession and quickly dried. 

An acid mixture for sponging the surface of the 
body, when it is desirable to excite the skin power- 
fully, as in jaundice and long-standing diseases of the 
liver, is made as follows: — 



Take of— 

Muriatic acid, three fluidounces. 

Nitric acid, two fluidounces. 

Water, five fluidounces. Mix. 
Add one-fourth of this to two gallons of water, for a 
sponge -bath. Make the whole of a comfortable warmth 
by first heating a portion of the water. Place both feet 
and legs in the water, and sponge the legs, thighs, in- 
sides of the arms, and over the region of the liver. 
This should be practised for ten or fifteen minutes, 
morning and evening. An earthenware or wooden 
foot-bath must be used, as the acid would corrode one 
of metal. 



THE EFFECTS OF THE WARM BATH. 453 

Salt-water Sponging. — A useful tonic sponge-bath 
is made by dissolving half a pound of bag salt in four 
gallons of water. 

Where the skin is dry and harsh, as is frequently 
the case in diarrhoea, dysentery, and febrile disorders, 
the use of soft soap is desirable. 

Whatever form of bath is used as a bath, it is still 
well to continue the tepid sponging of the patient in 
the morning, as long as he remains in the house. 

THE WARM, THE HOT, AND THE COLD BATH. 

Simple water baths are used for various purposes, 
and their effects vary with the temperature. We shall 
consider separately the warm, the hot, and the cold 
bath. 

THE WARM BATH 

Gently excites perspiration, and has a tranquillizing 
effect upon the system. If the object of the bath be 
to induce perspiration, it should have a temperature 
of 98° or 99°, as indicated by the thermometer, not by 
the hand. At this temperature the circulation is 
excited for the first few minutes, and then, if the water 
be not kept too hot, a feeling of languor, perhaps of 
faintness, steals over the patient, which, if he be very 
weak, must not be prolonged. The room and the bed 
must be kept warm, and after the bath he should be 
wrapped in warm clothing or go directly to bed. If 
the object of the bath be to tranquillize the system, to 
allay irritability or pain, to relax the muscles fatigued 



454: THE NURSING OF ADULTS. 

by spasm or by severe exercise, to induce sleep by 
soothing the brain, then the temperature of the bath 
must be somewhat lower than the above. It may 
range from 92° to 98°, according to the feelings of the 
patient, not of the nurse. The patient should not be 
kept too long in the bath; from ten to fifteen or twenty 
minutes will be generally sufficient. In some cases 
of deep-seated pain, the period may be prolonged with 
benefit to half an hour or an hour. The bath must 
not be taken while the stomach is engaged in the work 
of digestion. 

The bath is always to be covered with a blanket 
when the patient is in it. After a warm bath taken 
in the morning, the whole surface of the body should 
be briskly rubbed, otherwise chills will be felt later in 
the day ; particularly if the invalid intends to go into 
the open air, this friction must never be neglected. 

The warm oath is especially useful after any sudden 
chill ; at the inset of a cold ; after severe exertion of 
body or mind ; after prolonged exposure to cold ; after 
inward bruises ; when a feeling of lassitude and 
general illness occurs ; during times when epidemic 
diseases are prevalent ; when the skin is hot, harsh, 
and unper spiring ; during recovery from eruptive 
fevers, such as smallpox, measles, scarlet fever, diph- 
theria, and ulcerated sore throat ; in painful affections 
of the limbs, liver, stomach, or bowels ; in neuralgia 
and rheumatic affections ; in cramps and convulsions ; 
in nervous irritability, mental excitement, and sleep- 
lessness. 

TJie warm hath should he used with caution, and only 



THE EFFECTS OF THE HOT BATH. 4:55 

under medical advice, when the pulse is very weak, 
fluttering, or unequal, and when the breathing is much 
oppressed or embarrassed by disease of the heart. 

The warm bath at a temperature of 95° must prove 
a cooling agent to the body of a fever patient at 100° 
or 105°. The immersion should continue from fifteen 
minutes to an hour. 

In cases of delirium tremens with high fever, what 
is called cold super-fusion may be used while the 
patient is held in the warm bath. That is to say, 
from ten to thirty buckets of cold water are to be 
poured slowly over the head; hot water being con- 
tinually added to the bath to maintain its heat at 95°. 
This treatment generally produces sound sleep. 

THE HOT BATH 

Is a powerful exciting agent. It quickens the pulse, 
hastens the breathing, reddens the skin, and, on with- 
drawing from the water, excites copious perspiration. 
The temperature of the hot bath is from 99° to 110° — 
generally, 102° is hot enough for all remedial purposes. 
It is a remedy powerful for evil as well as for good. 
Its use requires care, and ordinarily should only be 
taken under the advice of the physician. It some- 
times will cut short a fever, relieve rheumatism, arrest 
an attack of bronchitis, and, in low relaxed conditions, 
act as a valuable restorative. The immersion ought 
rarely to be prolonged beyond five or ten minutes. If 
it lead to a sense of suffocation, headache, or rush of 
blood to the head, the patient is to be promptly re- 



456 THE NURSING OF ADULTS. 

moved, or the heat reduced by the addition of cold 
water. 

THE COLD BATH 

Is rarely proper during the stages of active disease. 
The patient must be pretty well advanced on the road 
towards recovery, before he can venture upon its use. 
The system remains too weak and unreactive for some 
time after severe illness to reply with sufficient energy 
to the application of cold. Nevertheless, the cold bath, 
when properly used, aids in the restoration of the con- 
valescent invalid. The temperature of the cold bath 
in summer should not be lower than five degrees 
below the temperature of the outer air, or ten below 
that of the room in which the bath is taken ; in winter, 
the water may be raised to 60° or 65° — even to 70° or 75°. 
The feelings of the person at the time he is about 
taking the bath must be consulted. At times, he 
may shrink from immersion in water of even a mode- 
rate temperature, which, on other occasions, has been 
delightful to him. The forcing of himself into the 
cold bath, under such circumstances, is apt to be fol- 
lowed by chilliness and prostration; instead, he should 
content himself with a tepid bath or simple sponging. 

LOCAL BATHS. 

The foot-hath is employed with benefit in colds, 
coughs, asthma, headaches, and slight fevers. One or 
two tablespoon sful of flour of mustard, added to a 
gallon of hot water, will produce a lasting glow on the 



LOCAL BATHS. 457 

skin, which will often relieve congestion of the head, 
and induce sleep in feverish cases. 

Acid Foot-Bath. 



Take of— 

Nitric acid, four fluidrachms. 

Muriatic acid, one fluidounce. 

Warm water, four gallons. Mix. 
To be used in a wooden or earthenware vessel. A 
valuable foot-bath in dyspepsia, with derangement of 
the liver and constipation of the bowels. 



The hip-bath is useful in sciatica and irritable bladder. 
Mustard flour improves its action. 

The sitz-bath is simply a hip-bath, with cold or hot 
water. 

The Shallow Bath. — A bath tub, some six feet long, 
is to be provided, and water (of a temperature of 70° 
to 80°) placed in it to the depth of eight to twelve 
inches. The patient sits in this bath, the limbs and 
body being well rubbed by an assistant, while water 
is gently poured over the head. The bath ought to 
continue for five minutes to half an hour, until the 
heat of the body is lowered. The colder the water, 
and the shorter the stay in it, the more stimulating 
and less sedative will be the effect. This bath is less 
exciting than the cold affusion (see below), and is 
chiefly employed where the latter would be improper, 
as, for example, where there is much nervous irrita- 
bility. It is also better for women, who seldom bear 
well the cold affusion. 



458 THE NURSING OP ADULTS. 



THE DRIPPING SHEET. 

This is a substitute sometimes used for the shallow 
bath. The patient stands upright in an empty bath, 
while the attendant, placed at his back, suddenly 
envelops him in a sheet dipped into water. The 
surface of the body is quickly rubbed by the atten- 
dant's flat hands for some three minutes, until the 
bather is in a glow; when a dry sheet is quickly sub- 
stituted for the wet one, and the rubbing continued. 
The whole process should be oyer in five or six 
minutes. 

COLD APPUSION. 

The patient is seated in an empty bath, and from 
four to six buckets of cold water (from 40° to 50°) are 
poured over his head and chest from a height of two 
or more feet. He is then quickly dried and replaced 
in bed. The colder the water, and the greater the 
height from which it is poured, the more stimulating 
the effect. Affusion, as thus practised, proves very 
valuable in the treatment of typhus fever. It is safe 
to resort to it when the heat of the body is perma- 
nently above its natural standard, when there is no 
feeling of chilliness, when the body is not wholly 
bathed in sweat, when there is not much irritability 
of the nervous system, and when there is great stupor. 
The effect is to lessen the heat of the body, to 
diminish the frequency of the pulse and the breathing, 
to render the tongue moist and soft, to decrease or 



LOCAL BATHS. 459 

remove the stupor, to procure sleep, and sometimes to 
produce a critical perspiration. It may be used every 
twenty-four hours if necessary. 

THE DOUCHE-BATH 

When it is desirable to apply a douche-bath to one 
or more of the joints, it is only necessary to fasten 
two or three yards of large-sized India-rubber tub- 
ing to the top of a cistern or a water-spigot. The 
patient must sit in an empty bath, into which the 
water may fall as it plays upon the limb. Or, the 
water may be poured from a pitcher held over the part 
to a height of several feet. In this way, first hot 
water and then cold may be made to fall upon the 
affected part, so as to produce a brisk stimulating 
effect in long-standing joint troubles. 

WET-SHEET PACKING-. 

The patient is closely enveloped in a sheet which 
has been dipped in cold or tepid water and well 
wrung out. He is then carefully wrapped in a 
blanket, covered with three or more blankets, and a 
down coverlet is tucked over all. He should remain 
thus for thirty, forty, or sixty minutes, lying on his 
side, or in a semi-recumbent position; the duration 
being timed by the sedative effect produced. The 
sweating is not generally excessive. At the conclu- 
sion the shallow bath, described above, may be used 
for two or three minutes as a tonic. 



460 THE NURSING OF ADULTS. 



THE WET COMPRESS. 

This consists merely of a roll of flannel or calico, 
dipped in cold water and wrung out, and then applied 
around the seat of pain. Over this a piece of oiled 
silk or muslin is to be worn. 

THE PLUNGE-BATH 

Is recommended after the wet-sheet packing and 
while the patient is perspiring. This treatment is 
useful in some cases where the patient is strong and 
vigorous, but it is a very dangerous procedure when 
there is delicacy of the internal organs. 

MEDICATED BATHS. 

Besides the warm, the hot, and the cold, general 
and local, baths which we have just described, other 
baths are employed in the sick-room, which are medi- 
cated in various ways. It is important that every 
woman should know how to prepare and use these 
medicated baths ; we shall therefore give plain direc- 
tions in regard to the preparation and employment of 
the principal ones, now commonly directed in medical 

practice. 

Sulphur Bath. 



Take of— 

Sulphuret of potassium (liver of sulphur), four 

ounces. 
Warm water, thirty gallons. Mix. 
Useful in itch, lead colic, paralysis from lead, etc. 





MEDICATED BATHS. 

Compound Sulphur Bath. 


461 


* 


Take of— 

Sulphuret of potassium (liver of sulphur), four 

ounces. 
Hyposulphite of soda, one ounce. 
Sulphuric acid, one flui drachm. 
Warm water, thirty gallons. Mix. 


• 




Alkaline Bath. 




' 


Take of— 

Carbonate of soda, one pound. 

Warm water, thirty gallons. Mix. 
Useful in long-standing scaly diseases of the skin, in 
obstinate rheumatism, in wandering gout, and gouty 
habits of body. Also in gravel, and in kidney and 
bladder troubles. 

The following recipe may be used for the same pur- 
pose: — 
Take of— 

Carbonate of potash, four ounces. 

Water, thirty gallons. Mix for the bath. 






Acid Baths. 






Take of— 

Nitric acid, one and a half fiuidounce. 

Muriatic acid, one to three fiuidounces. 

Warm water, thirty gallons. Mix. 
To be prepared in a wooden bath tub. The patient 
should remain in it for from ten to twenty minutes. 
Useful in cases where the liver is inactive, especially 
in invalids from a tropical climate, and those who have 
taken mercury. Employed in jaundice and in cases 
where the perspiration has a fetid or sour smell. 

Or, 
Take of— 

Dilute muriatic acid, one and a half fiuidounce. 
Warm water (95°), thirty gallons. Mix. 
Prepare in a wooden bath tub. This tonic warm 
bath is useful once a day in hysterical patients, to pre- 
pare them for a shower-bath. 




1 







462 



THE NURSING OE ADULTS. 

Iodine Bath. 



Take of— 

Iodine, one drachm. 
Iodide of potassium, one-half ounce. 
Solution of potassa {liquor potasses), two fluid- 
ounces. 
Warm water, thirty gallons. Mix. 
Useful in scrofula, long-standing rheumatic affections, 
and certain skin diseases. 



Borax Bath. 



Take of— 

Borax, four ounces. 
Glycerine, three fluidounces. 
Warm water, thirty gallons. 


Mix. 




Useful in 
skin. 


l scaly and other irritable diseases of 


the 



Creasote Bath. 



Take of— 

Creasote, two fluidrachms. 
Glycerine, two fluidounces. 
Warm water, thirty gallons. 
Useful in scaly skm diseases. 



Mix. 



Hemlock and Starch Bath. 



Take of— 

Extract of hemlock (comum), two drachms. 

Powdered starch, one pound. 

Warm water, thirty gallons. Mix. 
Useful in certain skin affections characterized by 
great sensitiveness and irritability. 



MEDICATED BATHS. 



463 



Artificial Sea - Water Baths. 



Take of— 

Bay salt, two pounds. 

Epsom salts, three ounces. 

Iodide of potassium, two drachms. 

Lime-water, one and a half fluidounce. 

Water, thirty gallons. Mix. 
This is a useful substitute for natural sea-water, when 
the latter cannot he obtained. It may be used hot or 
cold. 

Another receipt for making an artificial sea -water, 
which closely resembles the natural, is the following : — 

Take of— 

Common salt, nine pounds. 

Epsom salts, ten ounces. 

Chloride of magnesia, eighteen ounces. 

Chloride of potassium, four ounces. 

Water, thirty gallons. Mix. 
It is found that sea-anemones, and other denizens of 
the sea, will live and thrive in this imitation sea-water 
— a delicate test of its composition. 



THE TURKISH BATH. 



This is an elaborate process in which hot and cold 
water, heated air and vapor, friction and shampooing 
are combined. Before remarking upon its effects, we 
will give the description of it as it is practised in 
Constantinople, which method is more or less closely 
imitated in the various establishments for the purpose 
now in operation in most of our great cities. 

1. The person is undressed in a warm apartment, 
and three or four towels wrapped around him. 2. He 
enters another room moderately heated, and nearly 
dark, and lies down on a mattress to undergo a delicate 
manipulation until the perspiration begins to start. 
3. The attendant leads him into a room full of hot 



464 THE NURSING OF ADULTS. 

watery vapor, lays him down on the back, removes the 
towels and kneels at his side; bending over, he gripes 
and presses the chest, arms, and legs, passing from 
part to part. He brings his whole weight down with 
a jerk, follows the lines of the muscles with his thumb, 
draws the open hand over the surface, particularly 
round the shoulder, stands with his feet on the thighs 
and chest, and slips down the ribs; then, up again 
three times; and lastly, doubling the arms one after 
the other on the chest, presses and rubs down the 
person with both hands. The bather is now turned 
on his face, and the operation repeated upon the back. 
The next act consists in sitting on the floor by the 
side of a vessel containing hot water, and being 
rubbed down by a flesh-brush in the form of a glove. 
Under this process the dirt is rubbed off from the skin 
of apparently the cleanest person in rolls and flakes. 
Soap and water are now used in the ordinary manner, 
and the bath is over. 

Medical Effect of the Turkish Bath. — The bath is 
useful in removing local congestions ; in clearing the 
pores, and in inducing a healthy condition of the skin 
and mucous membranes; in freeing the blood from 
noxious matters; in imparting a sense of elasticity 
and vigor to the system ; in the first stages of a cold 
acquired from exposure; in long-standing rheumatism; 
in some inflammatory affections; and at the outset of 
a fever. It is injurious when there is any obstruction 
to the circulation of the blood; when the heart or 
vessels are affected with softening; when there are 
any symptoms of disease of the nervous system; when 



EFFECTS OF THE TURKISH BATH. 465 

there is a tendency to dizziness or fainting; and in 
advanced life. Women, during pregnancy or the 
monthly periods, should not employ it. More than one 
woman is known to have died in the Turkish bath in 
this country. It is, therefore, a remedial measure to 
be used with caution and discretion, and only when 
needed. The general effect of the hot air to which 
the person is first subjected in taking the bath, is to 
increase the force and rapidity of the circulation of 
the blood, and to induce free perspiration. If the air 
be too hot, or the stay in the hot-air chamber be too 
prolonged, the determination of blood to the skin and 
lungs becomes so great that the brain suffers. There 
is then a lessening of the heart's power and action, 
and a depression of the nervous force. 

THE SHOWER-BATH. 

This bath, by the agreeable glow and reaction upon 
the surface which it produces, is of service in many 
cases when the patient is strong enough to react 
under its influence. Cold water is to be preferred, 
and salt-water may be used with benefit. Brisk fric- 
tion of the skin with a coarse towel, or gloves, or a 
salt towel, should always follow the bath. An hour 
after breakfast is the best time for delicate persons ; 
those in robust health may take it immediately on 
rising. The shower-bath is objectionable when there 
is weakness or disease of the heart or any other inter- 
nal organ. In cases of fulness of blood in the head, 

30 



466 THE NURSING OE ADULTS. 

however, and also in long-standing bronchitis, it is 
often beneficial. 



THE YAPOR-BATH. 

A vapor-bath is of service in many cases of catarrh, 
bronchitis, pleurisy, inflammation of the lungs, rheu- 
matism, fever, affections of the bowels and kidneys, 
and skin diseases. Either simple steam, or medicated 
steam, may be employed. A vapor-bath in which the 
steam of hot water alone is employed will open the 
pores of the skin and produce perspiration. 

A simple apparatus may be gotten up at home at a 
very slight cost, suited to the administration of vapor- 
baths. All that is required is a flat tin box, having 
three or four short tubes soldered into the lid through 
which passes thick lamp-wick, and on the side a large 
tube stopped with a cork to allow spirits of wine to be 
poured in; and a flat, shallow dish, raised by legs of 
tin to a height a few inches above the wick of the box. 
The accompanying illustration shows a picture of the 
apparatus (the lamp for the spirits, tubes for the wicks, 
and the shallow basin for the water), from which any 
workman can construct one. To use this, pour alcohol 
into the box, and water into the dish (with any other 
substance which may be directed to medicate the bath), 
light the wicks, and place the patient in an open cane- 
bottomed chair, with one or more blankets drawn 
close around his throat, thrown over him so as to 
inclose the chair. Put the apparatus under the chair. 
When the water boils, its vapor will envelop the whole 





To face p. 466. 



Apparatus foe the Vapor-Bath. 



HOW TO TAKE A VAPOR-BATH. 



467 



body, and in a few minntes produce free perspiration. 
After this bath, the patient wraps himself in a 
blanket and goes to bed, so as to continue to perspire 
for some time. 

A few aromatic herbs thrown into the water, such as 
thyme, rosemary, marjoram, or lavender flowers, or a 
mixture of them, will pleasantly perfume the vapor 
and assist its effects. In the absence of the dried 
plants, a few drops of the essential oils, dissolved in 
alcohol, will answer the same purpose. 

In those cases in which a long course of vapor-baths 
is ordered, the following apparatus, more convenient 
and quite readily constructed by any carpenter, has 
been recommended : — 

Make a framework of wood to form a square in- 
closure; cover it with oil-cloth or other material, 
stretched on the framework, but leaving an opening 
at the top for the head. It should be large enough to 
inclose the patient while sitting on a cane-bottomed 
chair. To the upper part should be fastened a hood 
made of thick flannel, in such a fashion as to draw 
over the head, leaving only the face uncovered. The 
accompanying illustration will explain the arrange- 
ment. 

When gas is accessible, a gas-lamp or furnace may 
be used instead of the spirit-lamp to generate heat 
under the shallow dish. 

The patient can hold a thermometer in his hand, or, 
preferably, it may be fixed to the side of the frame- 
work, the bulb being inside and the graduated stem 
visible. 



468 THE NURSING OF CHILDREN. 

Such a covered framework and apparatus for a vapor- 
bath may be employed to take a dry heat air-bath. 



THE DRY HEAT AIR-BATH. 

This consists in the subjection of the whole surface 
of the body to hot dry air. The spirit or gas lamp 
placed, without the dish of water, in the inclosure 
described above, will heat the air to almost any tem- 
perature desired. Or a small room, with a window 
made to open at the top, so that the amount of heat 
can be regulated, may be used for the purpose of 
taking the hot air-bath. So soon as the air is heated 
to the desired temperature, as shown by the ther- 
mometer in the room, the patient undresses, and, 
with only a sheet thrown loosely around him, takes 
his seat. The weakly patient should commence with 
a temperature of 110°, which may be increased to 
120° or 130°, or more. The point is to find the de- 
gree most agreeable to the feelings, and which will 
induce, gently and gradually, free perspiration, which 
may be continued for some time. If the temperature 
be too high, it produces a sense of oppression and 
distress, and cannot be maintained for any length of 
time. While remaining in the hot air, the patient 
may drink freely of cold or tepid water, if thirsty. 
The water drunk will increase the amount of perspi- 
ration. So soon as the bath is over, the perspiration 
having been kept up sufficiently long, the patient 
should be washed with hot water and soap. 

This hot air-bath is of much service in long- 



HOW TO WASH THE HAXDS. 469 

standing skin diseases, when associated with other 
remedies. It is also useful at the outset of a cold, 
and in gouty habits. 

THE NURSE'S HANDS. 

The nurse, while looking after the cleanliness of her 
patient's person, must not neglect that of her own. 
Her hands ought always to be scrupulously clean. 
To aid her in keeping them so, we give — 

Miss Nightingale's Directions for Washing the Hands. — Com- 
pare the dirtiness of the water in which you have washed 
when it is cold without soap, cold with soap, hot with soap. 
You will find the first has hardly removed any dirt at all, the 
second a little more, the third a great deal more. But hold 
your hand over a cup of hot water for a minute or two, and 
then, by merely rubbing with the finger, you will bring off 
flakes of dirt or dirty skin. After a vapor-bath, you may peel 
your whole self clean in this way. What I mean is, that by 
simply washing or sponging with water, you do not really 
clean your skin. Take a rough towel, dip one corner in very 
hot water — if a little spirit be added to it, it will be more 
effectual — and then rub as if you were rubbing the towel into 
your skin with your fingers. The black flakes which will 
come off will convince you that you were not clean before, 
however much soap and water you have used. These flakes 
are what require removing, and you can really keep yourself 
cleaner with a tumbler of hot water and a rough towel and 
rubbing, than with a whole apparatus of bath and soap and 
sponge without rubbing. It is quite nonsense to say that any- 
body need be dirty. Patients have been kept as clean by 
these means on a long voyage, when a basinful of water could 
not be afforded, and when they could not be moved out of 
their berths, as if all the appurtenances of home had been at 
hand. 



470 THE NURSING OF ADULTS. 



CLOTHING OF THE PATIENT. 



The clothes of the invalid should be not only season- 
able, but beyond the season. When he leaves his room, 
first let him begin with winter clothing, unless it be 
summer, when he should wear a spring suit. The 
under-clothing, in particular, must be warm; while 
heavy outer garments weigh down and oppress the 
weak invalid, extra flannel next the skin will keep 
him warm without fatiguing him. The feet and legs 
must be kept warm and dry by thick stockings and 
drawers. If he rides in cool weather, a foot-warmer 
should be placed in the carriage. 

EXERCISE. 

In the chapter on Exercise (p. 167) we have treated 
this subject at length, and, therefore, may dismiss it 
here with a few words. 

The exercise of the invalid must be regulated, as to 
character and amount, by the organs affected and by 
his strength. In affections of the lungs, for instance, 
carrying weights or walking up a hill is injurious, as 
it taxes the strength and causes the heart to throw 
too much blood into the lungs. So, also, in these 
affections, rapid walking, and walking against the 
wind, are to be avoided. When the heart is diseased, 
active exercise must be used with caution. Indeed, in 
all cases active exertion must be approached slowly. 
Amusing games which do not call for violent motions, 
are the best forms of exercise with which the invalid 
can commence. 



TO IXVITE SLEEP. 



471 



SLEEP. 



The arrangement of the pillows on the sick-bed is a 
matter of prime importance, for it has much to do in 
driving sleep from the invalid's couch. The pillows 
should not be heaped up so as to throw the head for- 
ward upon the chest. When the patient can lie on 
either side, the pillow should be just thick enough to 
fill up the space between the head and the shoulder: 
a pillow should also be placed against the back. 
When a patient must sleep on the back, one pillow 
should be placed behind the lower part of the back, 
and with another the head supported so as not to be 
thrown forward. 

The nurse must be careful that no part of the pillow 
or bed-covers projects over the mouth or nose. When 
the disease is paralysis or any lung trouble, the nurse 
should be particularly attentive that the breathing 
be not obstructed in this manner. To prevent it, she 
should watch the patient until he sleeps, and then, if 
he be very weak, frequently visit his bedside to see 
that the mouth and nostrils are entirely free. Un- 
doubtedly many weak persons die from suffocation in 
this way, for, when the vital powers are much exhausted 
during low forms of illness, it takes but a slight ob- 
struction to the entrance of air into the lungs to extin- 
guish the spark of life. Such a patient, left in a calm 
sleep, is found dead in a few hours. The soft, yielding 
pillows, in which his head and face get buried, have 
suffocated him. This is no imaginary case: it hap- 
pens oftener than it is pleasant to think of. 



472 THE NURSING OF ADULTS. 

We have given (p. 186) a number of methods which 
may be employed to invite sleep to the invalid's 
bed. In addition, we append a number of receipts 
and specific directions suited to special cases of wake- 
fulness. 

When there is much mental excitement and forcible 
action of the heart, the application of cold water 
directly to the scalp is of service. This treatment is 
not suited to those patients whose wakefulness is due 
to exhaustion. 

A warm foot-bath will often induce sleep in cases 
of nervous irritability — it is particularly serviceable 
with children. 

Among the drugs which are employed as remedies 
against wakefulness (besides opium, chloral, garden 
lettuce, and hops, for the use of which see page 189), 
we may mention, with praise, henbane (hyoscyamus) 
and bromide of potassium. 

Of the tincture of hyoscyamus, of which it is difficult 
to procure a good preparation, a teaspoonful may be 
taken in water at bedtime. 

Better than henbane is the comparatively new salt 
now so well known to the non-medical public, the 
bromide of potassium. When sleeplessness is not 
caused by pain, this medicine is one of the most 
powerful and safe remedies we possess. It lessens the 
amount of blood in the brain, and brings quiet and 
refreshing slumber without any drawbacks. It is 
useful in those cases in which the face is flushed, the 
eyes suffused, and the head oppressed by a sense of 
fulness. 



RECEIPT FOR SLEEPLESSNESS. 473 



Take of— 

Bromide of potassium, half an ounce. 
Cinnamon (or common) water, two fluidounces 
(a wineglassful). Mix. 
Of this, the dose for adults is a dessertspoonful (two 
teaspoonsful) fifteen minutes before the evening meal, 
and the same dose, or three teaspoonsful, repeated in 
the latter part of the evening. 



TO CHANGE THE SHEETS UNDER THE SICK. 

"When the patient is too ill to be removed from the 
bed, it is important that the sheets should be changed 
quickly and dexterously while he is in the bed. We 
will suppose the sick man to be lying helplessly in the 
centre of his mattress. Spread the clean sheet, which 
has just been aired and warmed, upon the floor; roll 
one side tightly up half-way; then roll up one side of 
the sheet which is under the patient half-way, but in 
the opposite direction, close to his person; place the 
rolled part of the clean sheet alongside the rolled part 
of the dirty one, so that the unrolled half of the clean 
sheet shall occupy the place just uncovered by the 
rolling up of the half of the soiled sheet; turn the 
patient on his side, and push the rolled parts of the 
two sheets close under him; then gently let him fall 
upon his back over on the clean sheet, when the two 
rollers can easily be passed under the body, the one 
sheet coming off as the other is put on. 

TO CHANGE THE CLOTHING OF THE SICK. 

"When desirable, the clothing of the patient can be 
changed without uncovering the person or raising the 



474 THE CURSING OF ADULTS. 

head from the pillow. Pull the skirt of the bed-gown 
or chemise up from under the body of the patient, and 
draw the sleeves from over each arm. Place the arms 
of the patient in the sleeves of the clean gown, the 
body of which then throw over the head. Then, with- 
out lifting the shoulders of the sufferer from the bed, 
draw down and remove over the feet the soiled linen, 
and draw down and adjust under him the clean linen. 

TO MOVE THE PATIENT IK" BED. 

In cases of extreme debility, a strong towel placed 
under the back and another under the lower part of 
the body assist greatly in changing the position of 
the patient in bed. The very sick, if allowed to lie 
too long in one posture, contract bed-sores, hence the 
necessity of moving them occasionally. To turn the 
patient on the side, have him extend himself as 
straight as possible, then, without touching his arms, 
place one hand under the shoulder-blades and the 
other under the small of the back, and turn him 
towards you. Of course, if the patient be very weak, 
he cannot lie on his side unsupported. It will be 
necessary to place against his back one of the pillow- 
rests wo have described (p. 429), or a sheet tightly 
rolled up and tied. The invalid-lifter we have recom- 
mended (p. 432) is of great assistance in helping the 
patient to change his position and support himself. 

The sick should be handled as lightly as possible. 
The hands of the nurse should be passed under the 
pillows in raising the head and chest. The person of 



HOW TO MOVE THE PATIENT. 475 

the patient should never be touched with cold hands. 
"When it is necessary for the nurse to place her hands 
in contact with the skin of the patient, she should 
warm them, if they are at all cool, by holding them 
for a few moments in hot water. 

"When the nurse gets upon the bed to render assist- 
ance, the bedclothes should be so loosened that no 
weight or pressure shall be brought to bear upon the 
patient. No visitors should ever be allowed to sit on 
the side of the bed, for, by so doing, they tighten the 
clothes and irritate the person of the patient. 

HOW TO CARRY THE PATIENT. 

To carry a child is an easy matter. Few know how 
to properly lift and carry a grown person who is sick. 
The clothing to be worn while sitting up is to be 
adjusted before the patient is lifted. Place one arm 
under the bend of the knees, and the other round the 
back on a line with the armpits. Draw the patient 
well up against your chest, so that the head may rest 
on your shoulder. In this way the invalid, if not 
extremely heavy, may be carried from room to room, 
up stairs or down, without much exertion on the part 
of the carrier, and without injury to the burden. 
Carrying in a chair is awkward and unsafe. Putting 
the arms around the patient's neck, instead of sup- 
porting the back, often occasions severe pain. 




CHAPTEE III. 

COOKERY FOR THE SICK. 

t 

CONTENTS. 

The choice of common articles of food for the sick — Ladder of meat diet for 
invalids — Vegetable food needed by the sick — Jellies — The use of tea and 
coffee by the sick — The diet of health not that of sickness — The invalid's 
hours of meals — The preparation of common articles of food for the sick 
—Modes of cooking for the sick — Eeceipts for the sick-table : Nutritious 
beef-tea ; Eggs, cream, and beef-tea ; Gruel and beef-tea ; Extract of beef ; 
Essence of beef; A nourishing soup ; Restorative soup ; Strong broths for 
convalescents ; Chicken broth ; Lamb broth ; Baked partridge ; Broiled 
partridge ; Broiled tripe ; Calves' feet in milk ; Mutton or veal broth ; 
Chicken jelly ; Vegetable soup ; Soup tablets ; Oyster soup ; Broiled 
oysters ; Panned oysters ; Roast oysters ; Stewed oysters ; Scolloped 
oysters ; Frozen oysters ; Suet pudding ; Suet boiled in rice-milk ; Wine 
whey ; Lime-water and milk ; English milk porridge ; Spanish cream ; 
Soft custard ; Directions for beating eggs light ; Artificial ass's milk ; 
Artificial goat's milk ; Milk, flour, and iron ; Brandy and egg mixture ; 
Boiled rice ; Macaroni and vermicelli ; Rice pudding ; Irish moss blanc 
mange ; Caudle ; Oatmeal mash ; Corn meal gruel ; Tapioca ; Sago ; 
Tapioca or sago with eggs ; Corn-starch ; Bran bread ; Milk bread ; Potato 
yeast ; Corn bread ; Bread pudding ; Cracker pudding ; Milk toast ; Apple 
or other fruit with bread crumbs ; Bread jelly ; Gelatine jelly ; Iceland 
moss jelly ; Irish moss jelly ; Iceland moss and bitter jelly ; Calves' foot 
jelly ; Slippery-elm jelly; Rice jelly; Sago jelly; Toast-water; Tamarind- 
water ; Barley-water ; Thin barley-water for drinks ; Thick barley-water ; 
Almonds and milk — Nutritious enemata : Beef-tea and cream injection ; 
Cod-liver oil and bark injection; Quinine and beef-tea injection. 



OOKEEY has been called by Plato a form of 
flattery. A physician would be apt to term it 
a branch of pharmacy. The cook is often of more 

( m) 



FOOD IS A MEDICINE. 477 

service to the sick than the druggist. ~No nurse nor 
doctor should be ignorant of the art of. preparing 
food and drinks for the sick-table. Food is medicine, 
but, like the drugs from the shop of the apothecary, it 
fails of its effects when improperly prepared. 

The directions we give in this chapter for the 
choice and preparation of common articles of food for 
the sick, we have aimed to make as clear and practical 
as possible. Too often the receipts for cooking given 
in books on the subject are complicated, unnecessarily 
expensive, and wanting in important details. "We 
have admitted none here which have not received the 
sanction of those of our own acquaintance whom we 
know to be competent and intelligent nurses. Many 
of them have never before been published. 



THE CHOICE OF COMMON ARTICLES OF FOOD FOR THE 

SICK. 

In the second chapter of this book, in the article on 
Food, we pointed out the relative nutritive powers and 
the dangers attending the various articles of diet — 
animal food, vegetable food, and spices and condi- 
ments. It remains for us in this connection to afford 
some guidance in the choice of common articles of 
food for the purposes of a sick-diet, and then to give 
specific directions as to the best methods of preparing 
them, so as to please the palate and support the 
strength of the patient. 

"We will commence by presenting the following 



478 COOKERY FOR THE SICK. 

Ladder of Meat Diet for Invalids. 

"Whey. Sweetbread. 

Milk and lime-water. Boiled partridge. 

Plain milk. Chicken. 

Beef-tea. Mutton. 

Mutton broth. Roast leg of mutton. 

Milk is the most digestible form of animal food; 
the preparations from it furnish the most important 
articles of diet for the sick. Fresh milk is the most 
perfect food for extreme weakness. There is no 
stomach which will not bear it made into whey, or 
prevented from coagulating by the addition of lime- 
water. As we have already pointed out, it is most 
digestible when slightly warmed. 

If milk, instead of being fresh, is given to the sick 
soured or changed ever so slightly, it proves most 
injurious. The utmost care should, therefore, be 
taken in this matter by the nurse. 

Cream is of especial value in many long-standing 
cases of disease. It is often more readily digested 
than milk. 

Skim-milk has been found of great value in certain 
kidney diseases, and buttermilk in fevers and per- 
sistent diarrhoea, as we shall see more at length when 
we come to speak of these diseases. 

Butter, which is made up of the fatty elements of 
milk, is the lightest kind of animal fat. Although it 
is destitute of the sugar and some of the other ingre- 
dients of milk, it is both directly and indirectly a 
valuable article in the diet of the sick; directly, in 



THE CHOICE OF FOOD. 479 

scrofula, consumption, and other wasting diseases, 
because of its fattening powers, and indirectly, because 
it enables the patient to take more bread. 

Cheese, although it often disagrees with the sick, 
contains nutritive matter in a more concentrated form 
than any other article in general use as food. It is 
sometimes craved during convalescence, and then 
proves very useful. 

An exclusive milk diet has been employed with 
much success in the treatment of persistent affections 
of the stomach, of diabetes, and of other long-standing 
diseases. 

]SText to milk, beef-tea is, as indicated in the "ladder 
of meat diet," the most digestible form of animal food. 
The nutritive qualities of beef-tea depend very largely 
upon the manner in which it is made; we, therefore, 
call especial attention to the receipt for making it, 
which will be found on page 490. Thus prepared, it 
will be found both agreeable and wholesome. 

Mutton broth is a highly digestible article when 
well and freshly made. If "kept hot" for a number of 
hours, it loses its flavor, and is to be avoided as inju- 
rious. Next to it in digestibility comes sweetbread. 

Mutton is said, by competent authority, to be of all 
meats, when roasted, the most digestible, because it is 
the closest grained, most friable, and least infiltrated 
with fat. A tender roast leg of mutton is ordinarily 
very grateful to the invalid. We might have placed 
it with propriety a little higher in the "ladder of meat 
diet for invalids." 

JEggs sometimes disagree with invalids of a bilious 



480 COOKERY FOR THE SICK. 

temperament. In such cases they can usually be 
taken whipped up with sherry wine. Another excel- 
lent plan, in these instances of delicate stomachs, is to 
reject the white and give only the yelk. Eggs are 
best digested when soft boiled. 



VEGETABLE FOOD NEEDED BY THE SICK. 

It must not be supposed that animal food is all the 
patient requires. He needs vegetables as well as 
meat. "What Florence Nightingale, from her great 
experience, says of the English sick, is true also of the 
American, that "scorbutic sores have been actually 
known to appear among sick persons living in the 
midst of plenty in England, which could be traced to 
no other cause than this, viz., that the nurse, depend- 
ing on meat alone, had allowed the patient to be 
without vegetables for a considerable time, these 
latter being so badly cooked that he always left them 
untouched" 

In regard to the articles chosen, the patient's 
"fancies" will often greatly assist the nurse. As a 
general rule, that which is eagerly craved for by the 
sick person is needed, and may be allowed. 

The various preparations of arrowroot, tapioca, sago, 
corn-starch, and maizena (directions for the making of 
which we give a few pages hence) constitute nutritious 
and light articles for the sick-table. 

Bread should always find a place in the sick dietary. 
Many persons prefer homemade bread to baker's; 
their wishes in this respect should be consulted. 



THE ABUSE OF JELLIES. 481 

""Whole meal bread," or bran bread, used occasionally 
or daily, will often take the place of laxative medicines, 
and keep the bowels in a proper condition. 



JELLIES 

Are doubtless frequently abused in the sick-room. 
On this account Florence Nightingale is much op- 
posed to their use. She says : " Jelly is an article of 
diet in great favor with nurses and friends of the sick; 
even if it could be eaten solid, it would not nourish, 
but it is simply the height of folly to take one-eighth 
of an ounce of gelatine and make it into a certain 
bulk by dissolving it in water, and then to give it to 
the sick, as if the mere bulk represented nourishment. 
It is now known that jelly does not nourish, that it has 
a tendency to produce diarrhoea; and to trust to it to 
repair the waste of a diseased constitution is simply 
to starve the sick under the guise of feeding them. 
If one hundred spoonsful of jelly were given in the 
course of the day, you would have given one spoonful 
of gelatine, which spoonful has no nutritive power 
whatever. And, nevertheless, gelatine contains a 
large quantity of nitrogen, which is one of the most 
powerful elements in nutrition; on the other hand, 
beef-tea may be chosen as an illustration of great 
nutrient power in sickness, coexisting with a very 
small amount of solid nitrogenous matter. The 
reason why jelly should be innutritious, and beef-tea 
nutritious, to the sick, is a secret yet undiscovered, 

31 



482 COOKERY FOR THE SICK. 

but it clearly shows that careful observation of the 
sick is the only clue to the best dietary." 

Still, we would not banish jelly from the sick-room. 

Although it cannot be depended upon alone to 
nourish the patient, it acts admirably in connection 
with other articles by giving a flavor and relish to the 
meal. 



THE USE OF TEA AOT) COFFEE BY THE SICK. 

In regard to the use of tea and coffee by the sick 
much has been written. "We can record here with 
approval the words of the distinguished English 
philanthropist and nurse from whom we have just 
quoted : "A great deal too much against tea is said 
by wise people, and a great deal too much of tea is 
given to the sick by foolish people. "When you see 
the natural and almost universal craving in the sick 
for their 'tea,' you cannot but feel that nature knows 
what she is about. But a little tea or coffee restores 
them quite as much as a great deal, and a great deal 
of tea, and especially of coffee, impairs the power of 
digestion they have. Yet a nurse, because she sees 
one or two cups of tea or coffee restores her patient, 
thinks that three or four cups will do twice as much. 
This is not the case at all ; it is, however, certain that 
there is nothing yet discovered which is a substitute 
to the patient for his cup of tea; he can take it when 
he can take nothing else, and he often cannot take 
anything else if he has it not. I should be very glad 
if any of the abusers of tea would point out what to 



SHALL THE SICK HAVE TEA AND COFFEE. 483 

give to a patient after a sleepless night instead of tea. 
If yon give it at five or six o'clock in the morning, he 
may even sometimes fall asleep after it, and get, per- 
haps, his only two or three hours' sleep during the 
twenty-four. At the same time, you never should 
give tea or coffee to the sick, as a rule, after five o'clock 
in the afternoon. Sleeplessness in the early night is 
from excitement generally, and is increased by tea or 
coffee; sleeplessness which continues to the early 
morning is from exhaustion often, and is relieved by 
tea. The only patients I have ever known refuse tea 
have been typhus cases, and the first sign of their 
getting better was their craving again for tea. In 
general, the dry and dirty tongue always prefers tea 
to coffee, and will quite decline milk, unless with tea. 
Coffee is a better restorative than tea, but a greater 
impairer of the digestion. Let the patient's taste 
decide. You will say that in cases of great thirst, the 
patient's craving decides that it will drink a great deal 
of tea, and that you cannot help it. But in these 
cases be sure that the patient requires diluents for 
quite other purposes than quenching the thirst; he 
wants a great deal of some drink, not only of tea, and 
the doctor will order what he is to have, barley-water 
or lemonade, or soda-water and milk, as the case may 
be." 

THE DIET OF HEALTH NOT THAT OF SICKNESS. 

The diet best calculated to keep a person in health 
is not always that best suited to restore the sick. 



484 COOKERY FOR THE SICK. 

Beef, for instance, which is so wholesome and strength- 
ening to the well, cannot be eaten by the sick, whose 
weakened powers of digestion cannot act upon it. On 
the other hand, beef-tea, upon which a man in health 
will lose flesh and strength, proves the most nutritious 
of all articles of food for the invalid. Chemistry will 
not explain the reason for this difference. The condi- 
tion of the patient's stomach solves the problem, for it 
is not that which is taken into the stomach which 
nourishes, but that which, when there, is digested and 
assimilated. It is not, therefore, the amount of nutri- 
ment in the food so much as the amount which the 
digestive apparatus is able to extract from it, which 
is of value. The digestibility of food by the sick can 
only be determined by experience and observation. 
Here we see that this question of the choice of articles 
of food for the sick is one which must be studied sepa- 
rately. No acquaintance with chemistry, and no know- 
ledge of the values of different foods in health, will alone 
enable the nurse or physician to administer properly 
to the wants of the sick or convalescent. Those 
articles must be chosen, and those methods of pre- 
paring them selected, which extended observation has 
shown to be of most value. It is the result of this 
observation which it is our object here to record. 

We would also inculcate upon those having charge 
of the sick to note carefully the effects of the food 
given them; upon this much depends. The nurse's 
duty in this respect can be performed by no one 
else. The physician, who sees the patient only at 
intervals, cannot watch the direct influence of his diet; 



THE WORDS OF THE CENTENARIAN. 485 

he can merely tell whether there is progressive 
increase or loss of strength. The nurse should closely 
observe the immediate effects of the diet ordered, and 
report faithfully and minutely to the physician. 

THE INVALID'S HOURS OF MEALS. 

The laying in of food at intervals to meet the wants 
of the system is even in health somewhat of a tax to 
the digestive organs. The storing up of much food by 
a large meal to avoid future rather than satisfy present 
hunger, is a task which should not be imposed upon a 
sick stomach. In very bad cases and in low diseases 
the patient should not take regular meals at all, but 
the whole amount of nourishment needed in the 
twenty-four hours ought to be given in small portions 
at short intervals. Life may be endangered by allow- 
ing those very sick to go even a short time without 
supporting food or drink. In milder cases, a lunch 
between meals should be taken in order to remove 
both the necessity and inclination to eat too much at 
any one of the regular meals. The sick, and particu- 
larly those invalids who are subject to derangements 
of the stomach, should imitate a famous centenarian 
witness, who, when examined by a scientific judge, 
said he attained his great age by always "eating 
before he was hungry and drinking before he was 
dry." By this course his stomach was spared, for it 
was never overloaded, and never, therefore, had too 
much to do at one time. There is no fear of starving 
the patient by giving a little and often, for it is what 



486 COOKERY FOR THE SICK. 

is digested, not what is swallowed, that nourishes. If 
the weak stomach cannot retain a teacupful of beef- 
tea given every three hours, try it on a tablespoonful 
every half hour, or, if this be rejected, a teaspoonful 
every fifteen minutes. In other words, give the 
stomach less to digest, and it will do its work. 

Although it is often advisable to give food in di- 
vided portions at very short intervals, it should never 
be permitted to stand at the bedside or in sight of the 
patient, in the hope of tempting him to partake of it. 
This is a sure way of disgusting him. The food 
should only be brought into view at the proper 
time, and when the meal is over, at once removed, 
whether it be all eaten or not. Care ought to be 
taken not to bring more on the plates than will be 
needed, for the sight of a large mass will often 
prevent any being swallowed. Neither should food 
be prepared within the smell or sight *of the patient, 
nor even talked about in his presence. 

The utmost punctuality must be observed in giving 
food. The patient must not be kept waiting for a 
minute. The harm which may result from want of 
attention to promptness in this matter may be very 
great. "When food, expected at a certain moment, is 
not at hand, the disappointment is very apt to bring 
about a nervous condition, which incapacitates the 
sufferer from taking it when it comes. Thus a delay 
of a few minutes may cause several hours' fasting, 
which may endanger life. 

In the early morning hours it is ordinarily impos- 
sible for the patient to take solid food. The mouth is 



HOURS FOR MEALS. 487 

then parched, and the tongue heavily coated. A chop, 
a piece of fowl, or an egg is at this time utterly dis- 
tasteful. If, however, some concentrated liquid nour- 
ishment, as a few spoonsful of egg-flip or beef-tea, be 
given, the patient will be supported, and the way 
opened for solid food. 

Many lives would be saved, had nurses more gene- 
rally the knowledge, ingenuity, and perseverance to 
enable them to faithfully note the hours when their 
feeble patient could best take food, and to carefully 
observe the returning daily periods of faintness and 
sinking, in order to so arrange the giving of nourish- 
ment as to anticipate and avert them. 

The life of a patient who was sinking from want 
of food, was preserved by the question put to him by 
his physician: "But, is there no hour when you feel 
you could eat?" " Oh, yes," he said, "I could always 

take something at o'clock and o'clock." The 

experiment of giving him food at these hours was 
tried, and succeeded. Unfortunately, but few patients 
can give this information; the nurse and doctor must 
find it out by close watching. 

It is the duty of the nurse to think upon the subject 
of the patient's diet. She should remember how much 
he has had during the last twenty-four hours, and 
compare it with the amount he should have taken. 
She should provide in advance for his wants during 
the next twenty-four hours, and neither put him off* 
with what she happens to have on hand, nor keep him 
waiting for hours or even minutes while she is pre- 
paring that which she ought to have had ready in an- 



483 COOKERY FOR THE SICK. 

ticipation of his needs. To keep a patient waiting 
for food is, as we have said, to do him a positive in- 
jury — perhaps a very serious one. 



THE PREPARATION OF COMMON ARTICLES OF FOOD 
FOR THE SICK. 

Prof. Gross says, "The diet of the sick-room has 
slain its thousands and tens of thousands." The cele- 
brated Dr. Rush said, in his lectures, "A physician 
should spend six months in a kitchen before entering 
upon his practical career." We could readily show 
by other quotations the importance attached to our 
present theme, sick- cookery, by those most eminent in 
the medical profession. All thinking men and women, 
who have had opportunities for observation of the 
sick, must be convinced that infinite harm is done by 
ignorance or neglect in preparing food for weak 
stomachs. " Many patients," it has been well said by 
an accurate observer, "are annually starved in the 
midst of plenty, from want of attention to the ways 
which alone make it possible for them to take food. 
This want of attention is as remarkable in those who 
urge upon the sick to do what is quite impossible to 
the'm, as in the sick themselves, who will not make 
the effort to do what is perfectly possible to them." 

In preparing food for the sick, care should be taken 
not to have it any bulkier than can be helped. This 
is a nice point to determine. The preparations should 
not be too strong nor too thick, and yet not in such 
large quantity that the patient will reject a good 



HOW TO COOK FOR THE SICK. 489 

portion because he is not able to swallow so much 
at one meal. Do not compel him to digest a great 
bulk in order to get a little nutriment; avoid, there- 
fore, making soups, broths, etc., very weak. They 
should be as concentrated as the invalid is able or 
likes to take them. 

Sick-cookery, as has been aptly said, should more 
than half do the work of the poor patient's weak di- 
gestion. "What, then, shall we say of the nurse who 
brings, or suffers to be brought, to the bedside of her 
charge, that which would be repulsive or indigestible 
if prepared for a healthy person? Yet this is true of 
many of the soups, broths, jellies, and teas which are 
made for the sick. They are both disagreeable and 
hurtful. The patient, exhausted by disease, requires 
food that is plain, simple, pleasant, and nutritious; he 
too often gets that which is insipid, flatulent, and 
devoid of nourishment. 



MODES OF COOKING FOR THE SICK. 

Roasting is the most wholesome and palatable way 
of cooking animal food; baking can never take its 
place, especially for invalids. But birds when roasted, 
and still more when baked, are too dried up. Unless 
the cook be a very careful one, it is therefore better to 
boil the fowl or partridge — the best birds for the sick, 
all others being too dry or too oily. 

Animal soups stand in the front rank of the most 
nutritious dietetic articles for the sick. Every nurse 
should be skilful in making them. During the height 



490 COOKERY FOR THE SICK. 

of disease solid food cannot usually be taken, but so 
soon as recovery begins it becomes valuable. 



RECEIPTS FOR THE SICK-TABLE. 

The most digestible form of animal food, next to 
milk, is properly made beef-tea. We therefore call 
especial attention to the following, which we consider 
by far the best 

RECEIPT FOR NUTRITIOUS BEEF-TEA. 

The nurse should understand that the virtue of beef- 
tea is to contain all the contents and flavors of lean 
beef in a dilute form ; and its vices are to be sticky 
and strong, and to set in too hard a jelly when cold. 



A pound of Fresh Beef should be chosen from the 
loins or neck, and carefully freed from fat. It is then 
to be cut into fine pieces, and a very little salt, and 
five grains of unbroken black pepper, added. Pour 
over it a pint of cold water, and place it on the fire 
to simmer (not boil) for forty minutes. Pour off the 
liquor, and squeeze into it all the juice from the meat 
through a cloth. The meat is then to be thrown aside, 
and the tea returned to the fire to boil for ten minutes. 

Care must be taken lest too much salt be used, a 
fault frequently committed, and which renders the tea 
unpalatable to the patient. 



The addition of a small tablespoonful of cream to a 
t^acupful of this beef-tea renders it richer, but more 
nourishing. 

Some persons find the tea more palatable if a clove 
of garlic be rubbed on the spoon, with which the 
whole is stirred. 



RECEIPTS FOR THE SICK-TABLE. 



491 



A cup of this beef-tea taken on going to sleep, can 
often be borne when ordinary meals excite nausea. 

Certain patients will often take beef-tea when they 
refuse all other kinds of food. This is particularly 
the case in gastric fever, in which little else is some- 
times taken for weeks or months. 

It has been noticed that a small amount of beef-tea, 
added to other articles of food, increases their nutritive 
effects very greatly and out of all proportion to the 
additional quantity of solid matter thus furnished. 

A very nourishing broth is made by the addition of 
eggs and cream to beef-tea. The following is the 
receipt for 

Eggs, Cream, and Beef -tea. 



Wash a wineglassful (two ounces) of the best Pearl 
Sago until the water poured from it is clear. Then 
stew the sago in half a pint of water until it is quite 
tender and very thick. Mix with it half a pint of good 
boiling cream and the yelk of four fresh eggs, and 
mingle the whole carefully with one quart of good 
beef-tea (made as above directed), which should be 
boiling. Then serve. 



This very nutritious preparation is very useful in 
many cases of lingering convalescence, after an attack 
of sickness. 

The addition of gruel to beef-tea makes an excellent 
combination. It is made thus : — 



492 



COOKEKY FOR THE SICK. 

Gruel and Beef-tea. 



Take two tablespoonsful of Oatmeal, with three of 

cold water, and mix them thoroughly. Then add a 

pint of strong boiling beef-tea, made as above directed. 

Boil for five minutes, stirring well to prevent the oat- 

aeal from burning ; and strain through a hair sieve. 



This is a good restorative during convalescence 
from sickness before solid food can be taken. 



Extract of Beef 



Cut into small pieces a quarter or a half pound of 
Lean Beef, and cork it tightly in a wide-mouthed 
porter bottle, which is to be placed in a kettle of cold 
water. The kettle is heated until the water boils, and 
is kept on the fire for several hours. The bottle is 
then taken out, and the juice decanted, and seasoned 
with salt and pepper. 



Essence of Beef 



Take one pound of Gravy -Beef, free from skin and 
fat, chop it up as fine as mince-meat, and pound it in a 
mortar, with two tablespoonsful of soft water. Then 
put it into a covered earthen jar, with a little salt, 
cementing the edges of the cover with pudding paste. 
Place the jar in an oven, or tie it tightly in a cloth and 
plunge it into a pot of boiling water for three hours. 
Strain off the liquid essence, which will amount to 
about a wineglassful in quantity. Give two or more 
teaspoonsful frequently. 



r This preparation is very useful in conditions of great 
debility, or exhaustion from any cause. 





RECEIPTS FOE THE SICK-TABLE. 

A Nourishing Soup. 


493 




Take of— 

Beef, a shin. 

Cold water, two quarts. Boil until the meat is in 
shreds. Season with one red pepper pod. 
This soft jelly-like mass constitutes what is known 
as "the stock of soup." It can be kept for a week in 
a cool place. Whenever soup is wanted, take a tea- 
cupful of this stock and add half a pint of water, with 
vegetables, boil and strain. Then toast small pieces of 
stale bread and put into the soup. This preparation 
gives the extracted nutritive qualities of the meat and 
vegetables without the solid matter, and is often of 
great service when neither meat nor vegetables them- 
selves can be taken. 




An excellent Restorative Soup is made as follows : — 




Take one pound of newly -killed Beef or Fowl, chop 
it fine, add a tumblerful (one-half a pint) of soft 
water, four or six drops of pure muriatic acid (to be 
had of the druggist), from a half to a whole teaspoon- 
ful of common salt, and stir well together. After 
three hours the whole is to be thrown on a conical 
hair sieve, and the fluid allowed to pass through with 
slight pressure. On the flesh residue, in the sieve, 
pour slowly a wineglassful of soft water, and let it 
run through while squeezing the meat. 




The 
cold j 
posses 
glassf 

It i 
exteni 
with 
rendei 
formi] 


xe will thus be obtained over a tumbler 
uice (cold extract of flesh) of a red cob 
ssing a pleasant taste of soup. Of this a 
ul may be taken at pleasure, 
nust not be warmed (at least not to a £ 
d than can be effected by partially filling a 
it, and standing this in hot water); for 
:ed muddy by heat or alcohol, a thick c" 


ful of 
:>r and 
wine- 
greater 
bottle 
■ it is 
eposit 



494 COOKERY FOR THE SICK. 

If, from any special circumstances, such as a too 
frequent secretion of acid in the stomach, it is deemed 
undesirable to administer an acid, the soup may be 
well prepared by merely soaking the minced meat in 
simple distilled water. 

This soup is very valuable in cases of continued 
fever, in dysentery, and, indeed, in all diseases attended 
with great prostration and weakness of the digestive 
organs. "When the flavor is thought disagreeable, it 
may be concealed by the addition of spice. 

Strong Broths for Convalescents. 




These may be made by mixing together several kinds 
of meat, such as Beef, Mutton, and Veal, Cow's Shin, 
etc. Bones may be added, and any leavings of meat 
■which are not too stale. Allow a pound of meat to a 
pint of water. Stew some slices of onion, peppercorns, 
and salt, in a little hot water ; pour it over the meat, 
and cover close. Keep the mass from burning until it 
is nicely browned, then add the remainder of the water 
cold, and simmer, closely covered, for three or four 
hours. If there be much fat, skim it off when cold, 
and warm the liquor again. It must not be boiled fast. 

This is a strong broth, and beneficial when the appe- 
tite is good. 






Chicken Broth. 






Put a Leg and Wing of a Chicken in a quart of 
water, and boil down to half the quantity. Add a tea- 
cupful of hot water, a tablespoonful of rice or barley, 
a little pepper, salt, and parsley. If desired, a little 
potato may be added. 













RECEIPTS FOR THE SICK-TABLE. 

Lamb Broth. 


495 




Stew a Lamb Chop in a quart of water until it comes 
to shreds, add a tablespoonful of barley or rice, and a 
little salt and onion, if desired. Strain, and add a little 
parsley. 






Baked Partridge. 






Clean the Partridge as you would a chicken to roast. 
Fill with raw oysters, seasoned with butter, pepper, 
and salt. Sew it up. Place in the oven, well wrapped 
with butter, and bake. 






Broiled Partridge. 






Open the Partridge on the back (so as not to break 
the breast, which is usually preferred by the sick). 
Place it on the gridiron, and broil, basting with butter 
while broiling. Serve on hot plates. 






Boiled Tripe. 






See that the Tripe has been well cleaned. Boil it in 
water until it becomes quite soft, then pour off the 
water, and boil for a few minutes in milk, adding a 
little onion sauce. Serve in a tureen. 




The 


above is an excellent and readily digestec 
Calves' Feet in Milk. 


1 food. 




Boil two Calves' Feet in two pints of Milk and Water, 
for three hours and a half. 











496 



COOKERY FOR THE SICK. 

Mutton or Veal Broth. 



Take a Lean Mutton Chop; cold water a pint; a 
little salt and a tablespoonful of rice ; a little parsley, 
pepper, and salt. Boil for an hour, and serve. 



This broth will not keep, and therefore must be 
made fresh each time. 

Chicken Jelly. 



Cut up a Chicken, break all the bones, and put it 
into a stone jar. Fill the jar with boiling water, 
closely cover it, and keep the chicken in this boiling 
water for three hours and a half. Then strain the 
liquor, and season it with salt and mace. (The mace 
and spices, generally, are often disliked by the sick, 
and should then be omitted from all preparations. ) 



Vegetable Soup. 



Take two Irish Potatoes, one Onion, and a piece of 
Bread ; place them in a quart of water, and boil down 
to a pint, in a closely covered vessel ; add a little celery 
or parsley towards the close of the boiling. Salt and 
pepper may be employed at pleasure. 



Soup Tablets. — The following receipt is given by 
Dr. Reinsch, in the German Manuals of Pharmacy \ 
for making the soup tablets so much in use in the 
German army during the late war. 





RECEIPTS FOR THE SICK-TABLE. 


497 




Take eleven parts by weight of good Suet, melt in 
an iron pan, and make it very hot, so as to become 
brown; add, while keeping the fat stirred, eighteen 
parts of Rye Meal, and continue heating and stirring 
so as to make the mass brown ; add then four parts of 
dried salt and two parts of coarsely pulverized caraway 
seed. The mixture is then poured into tin pans some- 
what like those used for making chocolate into cakes. 
The cakes have the appearance of chocolate. A quan- 
tity of about one ounce of this preparation is sufficient 
to yield, when boiled with some water, a ration of good 
soup, and, the cakes being agreeable to the taste, may 
be eaten raw. 


- 




Oyster Soup. 






Take of— 

Oysters, a half dozen. 

Milk, a teacupful, with enough liquor of the 
oysters to make a bowl, a few allspice and 
cloves, a nice lump of butter, pepper and salt. 
Bring to a boil and skim. Then throw in the 
oysters and simmer. Add a few toasted crackers 
before removing from the fire. 






Broiled Oysters. 






Toast some Bread. Butter and pour the Liquor of 
Oysters over the toast ; set in the oven. Then broil 
the Oysters on a small gridiron, and place them over 
the toast, with butter and pepper. 






Panned Oysters. 






Take of— 

Butter, a large piece and put into a right hot pan. 
Liquor of oysters, pour into the pan ; so soon as 
hot, add the oysters and season light. Use no 
milk. A few tablespoonsful of Madeira wine 
may be added just before taking from the fire. 






32 





498 


COOKERY TOR THE SICK. 

Boast Oysters. 






The Oysters are to be well scrubbed. If not perfectly 
clean and white, they are not fit to enter the sick-room. 
The sight of dirty oyster-shells is sufficient to disgust 
the patient with the dish. After the oysters are nicely 
scrubbed, they are to be placed in an oven, in a pan. 
They lose their liquor if put over the coals, but when 
thus roasted they are served full of liquor. Eat with 
butter. 






Steamed Oysters. 






Scrub the Oysters clean. Put in a steamer over a 
kettle of boiling water until they open. Serve on the 
shells. Eat with pepper, salt, and butter. 






Scolloped Oysters. 






Take nice large Oysters, and put them with the 
liquor into a baking-pan, with milk, alternate layers of 
oysters and cracker crumbs, with plenty of butter, 
pepper, salt, and a little ground mace. Bake. 




Eav 

are be 
Fro 
Theo: 
by pla 
of ice. 
The 
should 


7 oysters are often grateful to the sick, 
st served on the shells — previously scrubb 
zen oysters are often pleasant during 
^sters and their liquor are frozen, in cold w 
cing in the open air, in warm weather by 

eye of the oyster is not readily digestibl 
. be removed for the sick. 

Suet Pudding. 


They 
ed. 

fever, 
eather 
means 

e, and 




Take one Egg, half an ounce of Suet to be chipped 
very fine in four ounces of Flour, and three-quarters 
of a pint of Milk. Bake or boil. 











EECEIPTS FOR THE SICK-TABLE. 



499 



The gravy of roast meat poured over this, makes a 
rich and agreeable dish. 



Suet loiled in Rice Milk. 



Take some Bice Milk (boiled rice and milk), and boil 
it. When nearly boiled enough, add a dessertspoonful 
of Beef Suet, already minced as small as bread crumbs. 
Boil slowly for a few minutes, and take off the scum 
as it rises. Or, the suet may be inclosed in a muslin 
bag. It must be eaten hot. 



This was once a favorite remedy for consumption. 
It is certainly an excellent means of getting fat into 
the system when there is a demand for that element, 
as in wasting diseases in which cod-liver oil is ordered. 

Wine-whey, properly made, proves in some cases of 
much service to the sick. It is prepared as follows : — 



Take a pint of fresh Milk, and place it on the fire ; 
as soon as it reaches the boiling point add as much 
good Madeira or Sherry Wine as will coagulate it. 
Then strain the mixture, and sweeten or flavor for use. 



Lime- Water and MilJc. 



Mix together equal parts of Lime-Water (to be had 
of the druggist) and Milk. 



This compound will sometimes be retained when 
all other food is rejected. As a variety, milk and 
soda-water in equal proportions may also be taken 
when the stomach is delicate and ejects everything 
else. 



500 



COOKERY FOR THE SICK. 



In this connection we may mention that the addi- 
tion of fifteen grains of bicarbonate of soda (to be 
had of the druggist) to the quart of milk, not only 
prevents it from turning sour, but renders it more 
digestible. 

English Milk Porridge. 



Rub up a tablespoonful of good Flour, or fine Oat- 
meal, in a little cold water, and when well mixed pour 
it slowly into a pint of hot milk, and boil for a few 
minutes, stirring well. 



Spanish Cream. 



Take of— 

Isinglass, one-half an ounce. 

New milk, one and one-half pints. Simmer, but 

do not boil. 
Eggs, the yelks of two and one-half, to be beaten 
with one-half cup of loaf sugar. 
Pour the hot milk on the eggs, spice to the taste, and 
put into moulds, allowing fiye hours for it to congeal. 



To make an excellent soft custard: — 





RECEIPTS FOR THE SICK-TABLE. 


501 




Take of— 

Milk, a pint. Place it to boil ; while boiling, take 
of 

Eggs, three; separate them, and beat the yelks 
up with sugar enough to sweeten to the taste, 
and with corn-starch, a teaspoonful, rubbed in 
smoothly. Then pour this egg and corn- starch 
mixture into the pint of boiling milk. Boil for 
a few minutes, and stir constantly to prevent 
lumping and burning. When the whole becomes 
a thick, creamy mass, remove. Have ready, in 
a dish, some 

Stale sponge-cake, wet with brandy or wine. 

Pour the custard over it, and cover all with the 
white of the three eggs whipped stiff, with a half 
teacupful of pulverized sugar, and flavored with 
vanilla. 

The dish may be served in a tempting and pretty 
way by ornamenting the top with currant jelly. 




As 
having 
ing di 


many dishes with eggs are spoiled by the eggs 
y been improperly beaten, we append the follow- 
rectionsfor heating eggs light: — 




Never employ an egg-beater. Use only a fork, silver 
or steel. Beat in one way only^ towards the left ; beat- 
ing first on one side of the dish and then on another, 
makes the mass heavy and causes it to fall. 

Attention to these directions will enable any one to 
beat eggs into a dry, light, and puffy condition. 






Artificial Ass's Milk. 






Take half an ounce of Gelatine and dissolve it in 
half a pint of Hot Barley Water. Then add two table- 
spoonsful of refined sugar, and pour into the mixture a 
pint of good new Cow's Milk. 











502 COOKERY FOR THE SICK. 

Artificial Goafs Milk. 



Chop an ounce of Suet very fine, tie it lightly in a 
muslin bag, and boil it slowly in a quart of New Milk. 
Sweeten it with white sugar. 



This is an excellent preparation in some cases of 
wasting diseases, where the unpleasant odor of goat's 
milk, prevents its being taken. 

Milk, Flour, and Iron. 



Beat up carefully a tablespoonful of Flour, one Raw 
Egg, and twenty grains of the Sweet Carbonate of 
Iron (to be had of the druggist), with half a pint of 
New Milk. Flavor with nutmeg and white sugar. 



Take this for lunch with a biscuit. It will be found 
very valuable in the early stages of consumption and 
wasting diseases. 

Brandy and Ugg Mixture. 



Take the whites and yelks of three eggs, and beat 
them up in two wineglassesful of Brandy, with a little 
sugar and nutmeg. 



Two tablespoonsful should be given every four or 
six hours in cases of great prostration. Often the 
addition of a teaspoonful of Huxham's tincture of 
bark to each dose will be found beneficial. 

To cook rice in the Southern manner, first wash the 
rice well with cold water, and then proceed as fol- 
lows : — 





KECEIPTS FOR THE SICK-TABLE. 

Boiled Bice. 


503 




Take of— 

Rice, a teacupful. 

Cold water, a quart ; add a little salt. Cover and 
boil with the lid on ; but do not stir. After it 
is boiled soft, take off the lid, and set on the 
back of the fire to dry. All the grains will then 
be found separated. 






Macaroni and Vermicelli. 






Add a little cold water to one ounce of either. Boil 

for a few minutes, then pour away this water, and boil 

in half a pint of milk, grate in cracker crumbs, butter, 

and add a little nutmeg ; or make into puddings, and 

• bake. 


• 


Macaroni is a cheap and valuable article of sick- 
room diet. It and vermicelli may be advantageously 
added to any kind of broth, or eaten with a chicken 
or a chop in place of vegetables. It is a perfectly 
safe food. 

Mice Pudding. 




Take two tablespoonsful of Rice ; Sugar to taste ; one 
Egg ; piece, size of a walnut, of Butter ; and one pint 
of Milk. Mix, and bake. 




Thi 


s is a most valuable article of food. 





504 COOKERY FOR THE SICK. 

To make Irish Moss Blanc Mange : — 






Take of— 

Irish Moss, only a small pinch, as it is very strong. 

Cold water, a teacupful. Soak for half an hour. 

Boiling milk, a pint. Mix, sweeten to taste, flavor 
with vanilla, strain through a hair sieve, and put 
in moulds, and on the ice to thicken. It should 
become so thick that it can be cut into slices. 




A Cream with which to serve the above, is made as 
follows : — 




Take of— 

Milk, a large coffeecupful. Place over the fire, 
and as it comes to a boil, beat up an egg briskly 
in it, and flavor with wine or brandy. 




This cream poured over the blanc mange adds both 
to its flavor and nutritive qualities. 

Caudle. 




Beat up one Egg with a wineglassful of Sherry, and 
add to it half a pint of fine hot Gruel. Flavor with 
sugar, nutmeg, and lemon-peel. 




Thii 
bility. 


3 is often useful in sleeplessness caused 
Oatmeal* Mush. 


by de- 




Take of— 

Oatmeal, four tablespoonsful. 
Boiling water, a quart. Mix, and boil for an hour 
and a half, adding a half teaspoonful of salt. 
Then turn it out in small cups, and eat it with milk. 











RECEIPTS FOR. THE SICK-TABLE. 

To make oatmeal gruel, see p. 403. 

To Make Corn-Meal Gruel. 


505 




To any amount of boiling water add sufficient salt 
to give it a flavor. Then stir in slowly enough corn- 
meal to make a thin gruel ; let it remain on the fire for 
fifteen minutes, stirring constantly, adding boiling 
water to keep it moderately thin. Serve with Milk 
and Sugar, Molasses, or Honey, as preferred. 


- 




To Prepare Tapioca. 






Take of— 

Tapioca, one-half teacupful. 
Water, one quart. Boil until perfectly clear. 
Sugar enough to sweeten to taste. 
Put in dish, with sliced apples or peaches, and place 
in the oven to bake. Eat with cream. 

Or, instead of baking with apples in this way, cut 
pineapple, fresh or preserved, or marmalade, into the 
clear boiled tapioca, and eat with thick, rich cream. 




Anc 
on p. { 

To 
Tapioc 


>ther receipt for preparing Tapioca will be 

105. 

prepare Sago. — Follow the above recei 

3a; see also p. 405. 

Tapioca or Sago with HJggs. 


found 
pt for 




Boil as above directed. Instead of apples or peaches, 
put in two eggs and a little nutmeg, and then bake. 
Eat with or without cream. 




Far 
using 


ma is prepared in the same manner as Ta 
milk instead of water. 


/pioca, 



506 


COOKERY FOR THE SICK. 

Corn- Starch. 






Take of— 

Milk, one pint, to be brought to boiling point. 

Corn-starch, three tablespoonsful, mixed with milk 
into a thin paste (and break in one egg if desired); add 
to the boiling milk, sweeten, put in a little pinch of 
salt, and stir to prevent burning. Boil until it becomes 
thick ; turn into a mould to cool. 






Bran Bread. 






Take of— 

Bran flour, one quart. 

Sour milk, one pint. 

Soda, teaspoonful. 

A little salt, and syrup to sweeten to the taste. Bake 
at once 






Milk Bread. 






Take of— 

New milk, one teacupful. 

Salt, a small half-teaspoonful. 

Boiling water, one quart. Mix, and allow to 
stand until about milk-warm. Then stir in flour 
until it becomes quite stiff, and add a teacupful 
of yeast. Set the vessel in another of warm 
water, and be careful not to let it get too hot. 
When cool, knead, and bake like ordinary 
bread. 




Mai 
yeast, 
whom 
we gb 


iy people, not knowing how to properly 
have sour bread. In the interests of the s 
sour bread is especially distasteful and h 
?e the following receipt for making potato 


make 
ick, to 
urtful, 
yeast : 





RECEIPTS EOR THE SICK-TABLE. 


507 




Pare, boil, and mash finely twelve Potatoes. Stir 
into these a large cup of Sugar, and one quart of boil- 
ing water. When cool, add one quart of cold water 
and half a pint or less of yeast. It is now fit for use. 

Shake before using. 




Bread made of this yeast never needs saleratus ; the 
sugar in the yeast prevents it from souring. It must 
be kept in a warm place. 

Corn Bread is very nice for breakfast for a sick 
person. It is made as follows : — 




Take of— 

Sour milk, one quart. 
Saleratus, two tablespoonsful. 
Butter, a quarter of a pound. 
Flour, three tablespoonsful. 
Eggs, three. 

Corn-meal, enough to make a stiff batter. Bake 
at once. 






Bread Pudding. 






Take- 
One pint of Milk ; two Eggs ; mix and sweeten. 
Place a few slices of buttered bread on top. Put 
in oven and bake. 




Or, 


' 






Grate a few pieces of Stale Bread into crumbs. 
Pour boiling milk over them, and cover close from the 
air. When the mass is quite smooth and cold, add 
Sugar and an Egg or two, a bit of Nutmeg, and a few 
drops of Lemon ; and bake or boil. 











508 


COOKERY FOR THE SICK. 

Cracker Pudding. 






Take of— 

Crackers, four, rolled fine. 

Boiled Milk, a pint, to be poured on the crackers. 

Butter, a piece of the size of a walnut. 

Eggs, two or three. 

Bake for an hour, and eat with wine sauce. 






Milk Toast 






Cut a round off a loaf and toast it uniformly brown ; 
lay it in a soup-plate, and pour in it as much boiling 
Milk as is necessary to soak it completely. Then 
butter and sprinkle with a little salt. 




This makes a delicious and nourishing article, and, 
from its soft texture, well suited to invalids. 

Apple, or other Fruit, with Bread Crumbs. 




Boil the Fruit well; then rub the pulp through a 
hair sieve. Make it thick enough to stand in a conical 
shape ; add a little butter, and surround the mass with 
a coating of crumbs of stale bread, browned before the 
fire. 




This 
useful 


5 is a nice relish, and generally a safe one. 
where fruit may be allowed, but not pastr 


It is 



RECEIPTS FOB THE SICK-TABLE, 



509 



Bread Jelly. 



Take a quantity of the soft part of a loaf, break it 
up, coyer it with boiling water, and allow it to soak 
for some hours. The water, containing all the noxious 
matter with which the bread may be adulterated, is 
then to be strained off completely and fresh water 
added. Place the mixture on the fire, and allow it to 
boil for some time, until it becomes smooth. The 
water is then to be pressed out, and the bread on cool- 
ing will form a thick jelly. Mix a portion of this with 
sugared milk and water, for use as it is wanted. 



This is a good food for infants at the time of wean- 
ing, and for sick children. 

An appetizing Jelly is made as follows : — 



Take of— 

Cox's gelatine, a fourth of a box. 

Cold water, a half pint. Soak for an hour and 

add : — 
Boiling water, a pint. 
White sugar, a half pound. 

Lemons, one and a half, both juice and grated 
rind. Stir well, strain through a flannel bag, and 
set to cool. If wine be allowed, add, before thin- 
ning, 
Madeira wine, half a wineglassful. 
Allspice and cinnamon are to be avoided in the mak- 
ing of this jelly, as they are ordinarily disagreeable to 
the sick. 

Oranges may be employed instead of lemons; or 
oranges and lemons may be mixed. 



510 



COOKERY FOR THE SICK. 





Iceland Moss Jelly 






Take of— 








Iceland 


moss, two ounces (to be had of the drug- 


gist). 








Water, 


one quart. First wash the 


moss 


m some 


cold water. Then boil it slowly in the 


quart of 


water until it becomes very thick, 


adding white 


sugar 


until it is made sweet enough. 


Strain 


through a cloth. Serve cold. It 


may be eaten, 


if preferred, with spices. 







Irish Moss Jelly. — Made in the same manner as 
Iceland Moss Jelly. 

Iceland Moss and Bitter Jelly. 



Take of— 

Iceland and Irish moss, each one ounce (to be had 
of the druggist). Boil slowly for three-quarters 
of an hour in a pint and a half of milk, strain 
through muslin, and add six tablespoonsful, dis- 
solved in two tablespoonsful of the compound 
tincture of bark, Huxham's tincture (to be had 
of the druggist). 
A dessertspoonful to be taken frequently in the 

course of the day. 



The above is a useful dietetic and tonic jelly in con- 
sumption and other wasting diseases. 



Calves' Foot Jelly. 



Take of— 

Calves 7 Feet, one set. 

Boiling water, a quart. Boil down to a pint. 
Sweeten while boiling. Flavor with lemon -juice 
and the grated rind of a lemon. Do not use cin- 
namon. Then strain through a flannel bag, and 
put in a bowl. After it is jellied, serve in glasses. 



RECEIPTS FOR THE SICK-TABLE. 



511 



Or, 



Put two Calves' Feet in one gallon of water, and 
boil down to a quart. Strain, and, when cold, skim off 
the fat. Take up the clear jelly, and place it in a 
saucepan with a pint of wine, half a pound of loaf 
sugar, the juice of four lemons, and the whites of six 
or eight eggs, beaten into a froth. Mix all well to- 
gether. Set the saucepan upon a clear fire, and stir 
the jelly until it boils. When it has boiled for ten 
minutes, pour it through a flannel bag until it runs 
clear. 



Slippery Elm Bark Jelly. 



Take four large spoonsful of chipped Slippery Elm 
Bark, and pour on a quart of water. Let it stand all 
night, and then stir and let it settle. The next morn- 
ing, pour off the water. Slice the rind of a lemon 
very thinly, and, with the juice, put it in the water 
strained. Let it gently simmer for fifteen minutes. 
Sweeten and pour in a mould to cool and harden, 
taking out the rind before putting it in the mould. 



Bice Jelly, 



Take a quarter of a pound of Rice Flour and a half 
pound of Loaf Sugar ; boil in a quart of water, until 
the whole becomes a glutinous mass. Strain the jelly 
off and flavor. 



This preparation of rice is nutritious and light. 
Sago Jelly. 



Take four tablespoonsful of Sago, one quart of water, 
the juice and rind of one Lemon, and enough Sugar to 
render it agreeable. After the mixture has stood half 
an hour, boil it until all the particles are entirely dis- 
solved, the mass being constantly stirred. 



512 COOKERY FOR THE SICK. 

A very excellent jelly for invalids may be made by 
thinly slicing and slightly toasting a penny roll, boil- 
ing it in a quart of water until it becomes a thick 
mass, and straining it upon a few shavings of lemon- 
peel. 

In making all these preparations, the utmost care 
must be taken to avoid scorching. For this reason, 
it is better to have a double boiler. 

Toast-water. 




Take of— 

Stale bread a slice, and toast right brown. 
Boiling water, a pint, to be poured over the toast in 
a large bowl. Sweeten, and put in a little nutmeg. 
Cover until cold. 






Tamarind-water. 






Take one ounce and a half of the best Tamarinds, 
and two ounces, each, of Currants and Raisins, 
washed and stoned. Boil in three pints of water 
until reduced one-half. Then add a bit of lemon-peel, 
and strain. 




The 
strong 

Bar 
or thi< 
thin; 


above is an agreeable drink when a soi 
ly flavored one is desired. , 
ley -water. — It may be made in two ways- 
3k. When wanted only as a drink, it sho 
if food be the object, it must be thicker. 


ir and 

— thin 
aid be 



RECEIPTS FOR THE SICK-TABLE. 

Thin Barley-water for drink. 



Wash some Pearl Barley very clean in two or 
three cold waters. To one or two tablespoonsful of 
the barley add a quart of boiling water, and let it 
stand uncovered near the fire for two hours. It must 
not be boiled. Add two or three slices of lemon and 
some of peel. Sweeten to taste. 



513 



This is a useful drink in irritable conditions of the 
stomach, bowels, kidneys, or bladder. 



TJiick Barley-water. 



After cleansing the Barley, as above directed, take 
two tablespoonsful or more of Barley to each pint of 
water. Simmer for two hours, adding a few opened 
raisins, and a little lemon-peel and sugar, during the 
last quarter of an hour. It need not be strained. 



"When this can be taken freely, it affords a con- 
siderable amount of nourishment. It is useful in 
great prostration, and in weakness of the digestive 
organs. 

Almonds and Milk. 



Take a large pinch of Isinglass and boil it with a 
tumblerful of Milk, half a dozen bruised Almonds, 
and two or three lumps of Sugar. To be taken warm 
once or twice a day. 



This is a very useful, soothing drink in cases of 
sore throat. Also in some cases of debility, with 
irritability of the stomach, and a tendency to diar- 
rhoea. 

83 



514 COOKERY FOE THE SICK. 



NUTRITIOUS CLYSTERS. 



The patient is sometimes unable, from exhaustion 
or the character of the disease, to" take food by the 
mouth. It then becomes necessary to nourish him, 
through the bowels, by nutritive injections. The fol- 
lowing will be found useful : — 

Beef-tea and Cream Injection. — An excellent nutri- 
tious injection may be made by mixing together from 
half a tumbler to a tumblerful of beef-tea, two table- 
spoonsful of cream, and a tablespoonful of brandy. 
The whole to be administered as an injection two or 
three times in the course of twenty-four hours. 

This will be found useful in cases of inflammation 
or cancer of the stomach, and in obstinate, long-con- 
tinued vomiting, where it is necessary to avoid giving 
food by the mouth. 

Another form of the same preparation may be made 
thus: Take a half tumbler or a tumblerful of restora- 
tive soup (see receipt on page 493), two tablespoonsful 
of cream, two teaspoonsful of brandy, and five drops 
of laudanum. For one injection. 

Cod-liver Oil and Bark Injection. — Take half a 
tumbler of essence of beef (sea receipt on page 492), 
four tablespoonsful of port wine, two tablespoonsful 
of cod-liver oil, and two teaspoonsful of Huxham's 
tincture of bark (to be had of the druggist). Admin- 
ister the whole of this as an injection every twelve 
hours. 

Quinine and Beef-tea Injection. — Take one table- 
spoonful of brandy, five grains of quinine, one tea- 



FOOD FOR EXTREME EXHAUSTION. 515 

spoonful of glycerine, two tablespoonsful of cream, 
and from half a tumbler to a tumblerful of beef-tea. 
This injection should be administered every six or 
eight hours. 







CHAPTEE IY. 



DIRECTIONS FOR THE ADMINISTRATION AND APPLICATION 
OF MEDICINES TO THE SICK. 



CONTENTS. 

The preparation and use of external applications — Poultices ; Bread and milk 
poultice ; Simple bread poultice ; Flaxseed-meal poultice ; Carrot poultice ; 
Slippery-elm poultice; Arrowroot poultice; Medicated poultices; Yeast 
poultice ; Charcoal poultice ; Bran poultice ; Onion poultice ; Mustard 
poultice ; Fig poultice — Cold and warm water dressings — To make a cold 
application in the absence of ice — Fomentations — Stuping — Steaming — 
Medicated lotions ; Sugar of lead and opium solution ; Aconite lotion ; 
Cooling lotions ; Lotions to allay itching of the skin ; Carbolic acid ; 
Borax and glycerine — Solution of arnica — Protective Solutions ; Solution 
of gutta-percha ; Collodion — Liniments — Blisters, and how to apply them 
— Cupping — Leeching — Directions for administering injections — The doses 
of the more common medicines — How to ascertain the dose for a child — 
Doses for adults — How to measure medicines — The time of the day to 
administer medicines — The intervals between each dose — Constitutional 
peculiarities in regard to the effects of medicines. 

T is our object, in the present chapter, to give 
some practical information in regard to the 
administration of medicines to the sick, and first in 
regard to 




THE PREPARATION AND USE OF EXTERNAL 
APPLICATIONS. 

Every woman should know how to make a poultice, 
but few do. In consequence of this ignorance, poul- 
(516) 



TO MAKE A POULTICE. 517 

tices, improperly made and applied, not only often fail 
of their desired effect, but, as we have in many cases 
seen, do actual harm. They chill and irritate the 
surface they were intended to warm and soothe. 
Blisters, lotions, cups, leeches, and other external 
applications, are constantly ordered by the doctor; 
we will furnish the nurse with plain directions for 
carrying out his orders. 

POULTICES. 

The uses of poultices are important and various. 
"We shall have occasion to recommend them in many 
affections. They should be made of such a thickness 
and consistence that they will adjust themselves 
evenly to the surface to which they are applied, and not 
run over the neighboring parts, nor the clothes of the 
patient. They should not be sticky, nor of too much 
weight or bulk, otherwise they will adhere to the skin 
and oppress it. As one of the principal objects of 
the poultice is to apply heat and moisture, so soon as 
it becomes cool and dry it must be removed and 
instantly replaced by another; ordinarily twice a day 
is often enough to make the change, excepting in 
warm weather, or in cases of much discharge. The 
outer surface of the poultice should always be covered 
with oiled silk, paper, or muslin, to confine its mois- 
ture and warmth. This precaution must never be 
neglected. If the prepared oiled silk, sold by all 
druggists, be not at hand, it is easy to oil some paper 
or muslin. Unless the poultice be thus protected, it 
very quickly cools and dries. It is well, also, to place 



518 HOW TO ADMINISTER MEDICINES TO THE SICK. 

over the inner surface of the poultice, that which goes 
next the skin, some thin gauze or bobinet, which will 
prevent the contents of the poultice from adhering to 
the skin, and render its removal easier for both nurse 
and patient. A poultice should never be applied to 
the skin hotter than the patient can bear with comfort; 
to burn the skin is simply to inflict needless torture. 

Poultices are used, as we have said, for various pur- 
poses; thus, some "to merely soften and relax the parts; 
some to relieve pain; some to act as astringents; 
some as antiseptics. 

The Bread and Milk Poultice is made as follows: — 




Pour boiling Milk upon the Crumbs of Stale Wheat 
Bread in a basin ; stir with the back of a spoon until 
the mass is brought to the thickness and consistency of 
mush. Spread upon a piece of cloth folded several 
times, and a little larger than the surface intended to 
be covered. After applying, cover with oiled silk. 




This is an excellent poultice, subject to the only 
disadvantage of quickly souring. It must, therefore, 
be frequently changed. Instead of milk, water may be 
used in the preparation of the poultice, we then have — 

The Simple bread poultice, which does not become 
offensive so soon. 




Cut slices of Bread half round a loaf, about three- 
quarters of an inch thick ; place them in a soup-plate, 
and pour boiling water upon them until they are quite 
soaked through. Smear a little Sweet Oil over the 
surface which is to go next the skin, and do not bieak 
the bread. 











RECEIPTS FOR POULTICES, 



519 



Flaxseed- Meal Poultice. 



Warm a wash-basin by scalding it with boiling 
water ; place in it sufficient Ground Flaxseed, and mix 
it well with boiling water, so as to have no lumps, into 
a thick, smooth, cohesive mass. Spread it a quarter 
of an inch thick upon folded muslin or soft linen ; lay 
over it a piece of thin gauze, which may be sewed 
around the edges so as to inclose the poultice in a bag, 
and thus prevent it from escaping into the clothing. 
Apply, and keep warm and moist by a cover of oiled 
silk, paper, or muslin. 



To make a poultice large enough to envelop one 
side of the chest, from half a pound to a pound of 
linseed-meal will be required. The naxseed-meal poul- 
tice is, for most purposes, the best which can be 
employed; it retains its heat and moisture for a long 
while, the oil it contains keeps it soft and prevents 
it from sticking, and it is always easily and quickly 
made. 

Poultices are also made from turnips, carrots, apples, 
and the more tender roots, by removing the skin, boil- 
ing them, and mashing into a soft pulp. 

Slippery-Elm Poultice. 



Moisten the powdered slippery-elm bark with hot 
water ; spread and apply as directed for flaxseed-meal 
poultice. 



This poultice is very light and soothing, it is there- 
fore well adapted for application to the eye or to 
burns and irritable sores. 



520 


HOW TO ADMINISTER MEDICINES TO THE 

Arrowroot Poultice. 


SICK. 




Mix the arrowroot into a smooth paste with suffi- 
cient cold water, then add enough boiling water to 
make it into a thick, adhesive mass. Spread and apply- 
as above directed. 




This is a most useful poultice for application to 
tender and irritable places. 

Medicated Poultices. — Any of the above poul- 
tices may be medicated by the admixture of various 
drugs. To make the poultice astringent, sprinkle over 
the surface some of Goulard's Extract, or in preparing 
it use, instead of water, a solution of acetate of lead 
(half an ounce of sugar of lead to the quart of water), 
or a decoction of oak-bark (an ounce of bruised oak- 
bark to a pint of boiling water). To make any poultice 
anodyne, sprinkle laudanum over the surface ; to get a 
stimulating effect, mix with it common salt, vinegar, 
or port- wine; to apply cold, partly fill a bladder with 
broken ice and spread over the surface of the poultice. 

Yeast Poultice. 




Take of— 

Flaxseed-meal or oatmeal, one pound. 

Yeast, one-half pint. Mix. 
Heat in a pot until the mixture swells. Spread on 
linen. 




Thi 
ulcers 


3 yeast, or fermenting poultice, is used ir 
, in gangrene and mortification, as an antL 


i fetid 
septic. 





RECEIPTS FOE POULTICES. 

Charcoal Poultice. 


521 




Mix finely -powdered recently -burned Charcoal with, 
the Bread, Oatmeal, or Flaxseed, before making into a 
poultice, in the manner above directed. 




The charcoal poultice is an excellent antiseptic, but 
subject to the objection of discoloring the parts to 
which it is applied, and thus concealing from the eye 
their true condition. This defect may be remedied, 
however, by covering the poultice, before application, 
with a piece of fine linen. 

Bran Poultice. 




Scald some Bran in a soup-plate, put it into a funnel 
bag, and lay upon the seat of pain. 




Thi* 
stoma< 


5 is a very soothing application in pain 
3I1 or bowels. 

Onion Poultice. 


of the 




Boil thoroughly some Corn Meal until a soft mush is 
produced ; cut several raw onions very fine ; stir the 
onions and juice into the hot mush ; heat through and 
spread upon cloths. 

Or, 

Partially roast some Onions ; mash them and spread 
upon folds of thin muslin. 




Wh 

fits, tr 
arms i 
poult h 
catarr' 


en children are threatened with convulsi< 
Le application of onion poultices to the le| 
s a useful one, and may avert the attack. 
3es are also of service in cases of crou 
1 of the chest in young children. 


Dns or 
£S and 
Onion 
p and 



522 HOW TO ADMINISTER MEDICINES TO THE SICK. 

Mustard Poultice. 



Mix the Flour of Mustard with warm (not hot) 
water ; spread evenly upon several folds of muslin ; 
cover the surface, which is to be placed next the skin, 
by a thin piece of gauze or cambric. 



The length of time during which this application 
can be borne, varies with the condition of the skin, 
and the sensibility of the patient. In a few minutes 
after it is applied, a feeling of warmth will usually 
be noticed; this sensation becomes more and more 
marked until, in about twenty minutes' time, it can no 
longer be borne with any degree of comfort. 

It is a general practice to use vinegar instead of 
water. But, if the mustard be pure, a better poultice 
is obtained with water than vinegar. The water em- 
ployed should be neither hot nor cold, but tepid. 

The mustard poultice should never be allowed to 
remain on long enough to produce a blister. The 
sore resulting from such a blister is a very trouble- 
some one and very painful. We wish to particularly 
caution the nurse and patient on this point. Persons 
have sometimes fallen asleep under the first soothing 
effects of the mustard poultice, and been awakened 
afterwards by the agony from the severe and dangerous 
burn resulting. When the patient is unconscious, of 
course the effect must be carefully watched. 

In the case of children and delicate adults, the mus- 
tard flour should not be used pure, but mixed with 
equal parts of wheat or rye flour. For very young 



THE OLDEST POULTICE ON" RECORD. 523 

children, one part of mustard to four or five of flour 
is the proper proportion. 

If a still milder application be wanted, mix the 
mustard with syrup or molasses instead of water. 
This may be borne for two or three hours. 

A. fig is often useful as a soothing application in- 
stead of a poultice, especially in gum-boils. This 
remedy was known to Hebrew medicine. Thus we 
are told: — 

"And Isaiah said, Take a lump of figs, and they 
took and laid it on the boil, and he recovered." (2 
Kings, xx. 7.) 

COLD AND WARM WATER DRESSINGS. 

The application of cold water is useful and curative 
in many cases of inflammation affecting the external 
parts of the body. The means of application are va- 
rious. 

The limb may be wrapped in old soft linen, and a 
little stream of cold water directed over it from the 
stopcock of a vessel placed above it, the overflowing 
water being conducted by a proper arrangement of 
oil-cloth into a tub or bucket at the side of the bed. 

Or, the affected part may be covered with a thin 
wide piece of sponge, or some folds of linen, on which 
is placed a bladder partially filled with pieces of ice. 

Or, the diseased surface may be covered with lint, 
kept moist by means of a piece of common lampwick, 
one end of which is placed in a basin of cold water, 
and the other extended over the enveloping lint. The 



524: HOW TO ADMINISTER MEDICINES TO THE SICK. 

wick, by its siphon-like action, conveys the water 
from the basin to the limb. 

In all these methods, the part to which the water 
is applied is to be exposed to the air, to promote 
evaporation. 

When ice cannot be had, the water may be cooled 
by a freezing mixture. The number of those mixtures 
is very great. "We shall mention only a few of the 
best and most convenient. 



Add one part of alcohol to six of water. 
Or, 

Take of— 

Muriate of ammonia, 
Nitrate of potash, each five ounces. 
Water, one pint. Mix. 
Either of these mixtures will make a cold application 
in the absence of ice. 



The application of cold water is not always well 
borne. Patients who are young and strong bear it 
better than the old and weak. The season of the year 
has an influence — cold water being more comfortable 
in summer than in winter. The feelings of the patient 
should always be consulted; if cold applications occa- 
sion discomfort and pain, they must be exchanged for 
warm. 

Warm water applications are more used at the 
present day than cold, and are ordinarily better borne 
by the patient. 

In many inflammatory affections, where a relaxing 
effect is wanted, they are to be preferred to cold water 
applications, which have a constringing influence. 



FOMENTATIONS AND STUPES. 525 

The simplest fomentation consists in saturating a 
large piece of soft thick flannel with hot water, and 
applying it to the affected part, covering it with oiled 
silk, paper, or muslin. As this application requires 
frequent renewal, a second piece of flannel should be 
kept at hand to replace the other the instant it is 
removed. Fomentations, particularly when medi- 
cated with some of the anodyne lotions, the formulas 
for which we are about to give, afford great relief to 
pain and spasm. 

Stuping is a sort of fomentation employed in 
diseases of the eyes, nose, mouth, ears, and throat. 
The procedure is a simple one : Roll a piece of flannel 
into a ball, immerse it in boiling water, and, when 
thoroughly wet, put it in a pitcher or bowl, which is 
to be held near the affected part, so that the steam 
may rise around it. As fast as the flannel becomes 
cool, rewet it. Laudanum or the tincture of bella- 
donna may be sprinkled upon the cloth, if their effects 
are desired. 

Steam may be applied directly to a part by means 
of a rubber tube, one end of which is attached to a 
small boiler placed over a spirit-lamp, or to the spout 
of a teakettle, and the other passed under the bed- 
clothes, to reach any desired portion of the body. 



MEDICATED LOTIONS. 

Instead of cold or warm water, it is often desired 
to use a medicated lotion. "We therefore append the 
receipts for a number of the most efficient. They are 



526 HOW TO ADMINISTER MEDICINES TO THE SICK. 

to be employed in the manner we have just directed 
for warm and cold water applications. 

Lotion of Sugar of Lead and Opium. 




Take of— 

Sugar of lead, one-half an ounce. 

Powdered opium, one-half a drachm. 

Boiling water, two quarts. Mix. 
To be applied by means of a piece of old flannel 
wrung out in the solution — not forgetting to cover the 
flannel with oiled silk, paper, or muslin, in order to 
confine the heat and moisture. 




The above is a very grateful application in many 
painful affections. We shall have occasion to pre- 
scribe it frequently when we come to the treatment of 

diseases. 

Aconite Lotion. 




Take of— 

Tincture of aconite, one and a half fluidounce. 

Water, four fluidounces. Mix. 
Useful to relieve suffering in neuralgia and other 
affections in those cases in which the pain is not deep- 
seated. 






Cooling Lotions. 






Take of— 

Spirit of mindererus, two tablespoonsful. 

Spirits of wine', a wineglassful. 

Rose-water, a tumblerful. Mix. 
This is a cool, evaporating lotion, especially useful 
for application to the scalp in diseases of the brain. 

Or, 
Take of— 

Muriate of ammonia, one-half an ounce. 

Spirits of wine, two tablespoonsful. 

Vinegar, three tablespoonsful. 

Water, a small tumblerful. Mix. 











THE RELIEF OF ITCHING. 527 
LOTIONS TO ALLAY ITCHING OF THE SKIN. 

One of the best applications to allay itching is good 
cider vinegar sponged over the parts. 

A warm bath followed by the plentiful use of home- 
made soft soap or of carbolic acid soap is very useful 
for the relief of the tormenting itching which attends 
some skin and nervous diseases. 

Itching of the skin in old persons is frequently 
relieved by the application of glycerine by means of 
a sponge. Or, carbolic acid may be added to the 
glycerine thus : — 




Take of— 

Fluid carbolic acid, one teaspoonful. 
Glycerine, two tablespoonsful. 
Water, a tumblerful. Mix. 
Apply by means of a sponge. 




Anc 


)ther preparation for relieving itching is t' 
Borax and Glycerine. 


aat of 




Take of— 

Borax, three or four teaspoonsful. 

Glycerine, a tablespoonful. 

Kose-water, a tumblerful. Mix. 
The affected parts are to be washed with glycerine 
or honey soap and warm water, and this lotion applied 
several times a day. In severe cases morphia may be 
added to it — ten grains of the muriate of morphia to 
be dissolved in the lotion. 











528 HOW TO ADMINISTER MEDICINES TO THE SICK. 

Solution of Arnica. 



Take of— 

Tincture of arnica, three teaspoonsful. 

"Water, a tumblerful. Mix. 
This is an excellent lotion in sprains, bruises, and 
slight burns, in which the skin is not broken. 



PROTECTIVE SOLUTIONS. 

There are various solutions which can be painted 
over the skin to protect it from the action of the air 
or from friction. One of these is the caoutchouc or 
India-rubber solution. It is made by dissolving 
some thin slices of India-rubber in chloroform. The 
solution of gutta-percha may be obtained ready made 
from the druggist. It is useful to paint over surfaces 
from which the skin has been abraded or excoriated, 
and to prevent threatened bed-sores. 

Collodion, which may be obtained from any apothe- 
cary, makes also an excellent coating for the skin. It 
is, however, liable to crack. This cracking may be 
prevented by mixing one part of collodion with two 
parts of castor oil. This mixture will be found a 
valuable varnish in excoriations, abrasions, and slight 
burns. It forms a good artificial skin to take the 
place of that which has been injured or destroyed. 

LINIMENTS. 

An excellent liniment, of frequent use in the sick- 
room, is made by dissolving lump camphor in sweet oil. 
Place a saucer of sweet oil on the fire, and dissolve in 



RECEIPTS FOR LINIMENTS. 529 

it as much camphor as it will take up. A little bees- 
wax may be added. 

A mixture of equal parts of sweet oil and lime-water 
makes a soothing embrocation in cases of burns, 
chapped hands, and abrasions. 

A mixture of one part of tincture of aconite with 
four of soap liniment is useful in neuralgia and other 
pains, well rubbed into the skin. 

Another useful liniment to relieve pain is made by 
mixing equal parts of liniment of ammonia, chloroform 
liniment, and soap liniment. 

A stimulating reddening liniment is made by adding 
cayenne pepper and oil of mace to soap liniment. 
About thirty grains of the pepper and thirty drops of 
the oil to eight ounces of the liniment. It is useful 
to make counter-irritation in cases of bronchitis and 
muscular rheumatism. 

BLISTERS. 

We are indebted to the Arabian physicians for a 
knowledge of the practical value of blisters. The 
ancient Greeks and Romans used mustard plasters for 
the purposes for which we now employ fly blisters. 

Blisters are external applications to the skin, which, 
by the irritation they produce, excite inflammation and 
cause an accumulation of fluid under the scarf skin, 
which is thus separated and raised from the true skin. 
"Various substances have been used for this purpose, 
such as boiling water, strong acid, mustard, harts- 

34 



530 HOW TO ADMINISTER MEDICINES TO THE SICK. 

horn, lunar caustic, iodine, turpentine, garlic, an 
tartar emetic, but none are equal to the Spanish fly. 

The Value of Blisters. — There is a popular adage 
that "blisters are always safe; if they do no good, 
they can do no harm." This saying is not a true one. 
Like all remedies powerful for good, they have a power 
for evil also. To children, and the aged and infirm, 
they should be applied with caution. No child under 
five years of age should ever have a blister applied, 
and in the case of older children the blister should be 
allowed only to remain long enough to redden the 
skin, after which a flaxseed or bread and milk poultice 
should be used. The most terrible suffering, and 
even death, has followed the use of a blister upon 
young children. Those enfeebled by age or a long 
sickness bear blisters badly. They should not be 
applied over the windpipe of children, nor upon the 
breasts of women. 

HOW TO APPLY A BLISTER. 

The common blister is made by spreading fly oint- 
ment (blistering cerate) on a piece of thick glazed 
paper, kid or split sheepskin, or on adhesive plaster. 
The latter is the best material; for, by leaving a mar- 
gin in spreading, the plaster is easily made to adhere 
by warming the uncovered margin and pressing it 
carefully on the part. "When the blister is not spread 
on adhesive plaster cloth, it is confined by means of a 
roller bandage, or preferably by a few strips of sticking 
plaster. 

Before applying the blister, the part of the skin to 



HOW TO APPLY A BLISTER. 531 

be covered by it must be shaved in order to remove all 
hairs, and then gently washed with soap and warm 
water, and thoroughly dried with hot flannel. It is 
not necessary to warm the blister itself, but merely 
the margins when it is spread upon adhesive plaster. 
The edges of the blister are to be clipped in numerous 
places, and a few cuts, about half an inch long, made 
on the back, so as to ease the pressure when it rises. 

To prevent strangury (irritation of the bladder), 
which sometimes follows the use of a blister, a piece 
of thin tissue paper, wet with spirits of camphor, 
should be interposed between it and the skin, or, what 
is better, a few grains of morphia sprinkled upon its 
surface before application. This precaution is par- 
ticularly necessary in the cases of young children, or 
of persons of a nervous temperament. In addition, 
it is well, in such instances, to have the patient drink 
freely of flaxseed tea, barley or gum-arabic water, 
with a little sweet spirits of nitre. 

When it is desirable to have the blister to act 
quickly, a mustard plaster may be applied over the 
part ten or fifteen minutes before it is put on. 

The Time the Blister should Remain on. — The time 
depends upon the age of the patient, his strength, and 
his susceptibility to its action. As a rule, from six 
to eight hours is the proper period. If the skin be 
sensitive and delicate, less time will do. It should be 
taken off on the appearance of the first sign of blister- 
ing. In children, two or three hours will be the utmost 
limit. Indeed, in their case, the blister had better be 
taken off at the end of an hour and a half, even al- 



532 HOW TO ADMINISTER MEDICINES TO THE SICK. 

though the skin may be found unchanged, and a warm 
poultice applied which will keep up the action and 
produce the desired result. 

In adults it is never necessary to keep the plaster on 
until the blister is completely formed. "When the skin 
is well reddened, and a few little bladders have ap- 
peared here and there, the use of a soothing poultice 
or a warm water dressing will complete the operation. 
In taking off the blister, care should be observed that 
every particle of the fly ointment is removed. 



HOW TO DRESS A BLISTER. 

The bladders should never be cut, unless it is desired 
to keep an open sore for purposes of counter-irritation. 
The raised scarfskin should be punctured with a large 
needle, so that the water may gradually drain off. The 
raised portion of the skin will then fall back upon and 
protect the raw surface beneath from the action of the 
air. In some cases, in fact, particularly in the treat- 
ment of catarrh of the chest, the best results are ob- 
tained by leaving the blisters unopened. The water 
of the unopened blister affords one of the best possible 
applications for the raw surface, and prevents the possi- 
bility of the formation of troublesome sores in children 
or in persons of an irritable habit of body. The dress- 
ing under these circumstances consists merely of a 
piece of lint smeared with fresh lard or sweet oil, 
applied twice a day over the blister. 

After the discharge of the water from the blister, 
soft cotton wadding applied over the part with the 



HOW TO DRESS A BLISTER. 533 

woolly surface next the skin, is an admirable dressing. 
If in the course of a few hours this should become 
soaked with the discharge, as much of the cotton may- 
be removed as can be done without disturbing the 
loose skin beneath, and the whole covered with a fresh 
dry layer of cotton. This will ordinarily be all that is 
required. The cotton is allowed to stick to the skin 
of the blistered part, and when a new layer of skin 
forms, the old.scarfskin and the cotton come off to- 
gether, leaving a whole smooth surface below. 

If the blistered surface become red and painful, 
disturbing the patient and making him* feverish, an 
arrowroot or slippery-elm poultice will afford relief. 
In such cases Prof. Gross recommends the applica- 
tion of common white-lead paint, as the most soothing 
of all dressings. It should be put on in a thick layer, 
covered with cotton and confined by a bandage. 

When the Ulster is to he Tcept open, instead of punc- 
turing the bladder with a needle, the whole of the 
raised skin should be carefully clipped off with a pair 
of scissors, and the ointment of savin or some other 
irritating ointment applied. The part must be covered 
constantly with a poultice or moist cloths, and, when- 
ever the discharge lessens a little, more of the irri- 
tating ointment used. 

Instead of the common fly-blister, cantharidal col- 
lodion is a very convenient and neat application for 
raising a blister. It can be obtained from any drug- 
gist in a bottle. It acts more quickly than the 
ordinary blister. Apply it by means of a camel's- 
hair brush. Cover the surface to be blistered 



534 HOW TO ADMINISTER MEDICINES TO THE SICK. 

thoroughly with it, and lay over it at once a piece of 
oiled silk, paper, or muslin, to prevent the evaporation 
of the solution. Cantharidal collodion can be applied 
evenly to the skin, and cannot slip out of its place, 
as sometimes happens with an ordinary blistering 
plaster. 

Cantharidine blistering tissue is also a very elegant 
preparation for blistering purposes. It ca'n be ob- 
tained from the best druggists. Its chief advantages 
are that it can be quickly adjusted and taken off, that 
it acts quickly, and that it does not give rise to sores 
nor strangury. 

HOW TO BLISTER QUICKLY. 

Sometimes it is necessary to blister the skin im- 
mediately, as for instance in croup, when, if the disease 
be not speedily checked, death may result. A stick 
of lunar caustic rubbed over the surface will often 
raise a blister in a few minutes. A sponge dipped in 
boiling water and applied will have the same effect. 
Of course, this is a painful procedure, and only to be 
resorted to in an emergency. The application of a 
mixture of equal parts of powdered hartshorn and 
lard will form a blister in five or six minutes. 



THE APPLICATION OF LEECHES. 

Leeches are quite frequently ordered by the phy- 
sician, and their application often falls to the lot of 
the nurse. Some directions, therefore, in regard to 



HOW TO APPLY LEECHES. 535 

the manner of using them will be of value to her, 
especially as, if she, be not accustomed to handling 
them, the bare idea of touching one may be repugnant 
to her. This repugnance is, perhaps, natural against 
an animal whose instincts, however serviceable they 
may be to us, lead it to suck our life-blood. 

The foreign leeches — the Swiss, German, French, and 
Spanish — are better than our own American leeches, 
though smaller in size. The size of a leech has 
nothing to do with its usefulness, a small, hungry, 
active one taking more blood than a large, heavy, 
sluggish one, which falls into a state of stupor in the 
midst of its work. The American leech is not, there- 
fore, often employed, as it is difficult to get it to bite, 
and when it does take hold it generally sucks idly. 

The leech, though such a voracious, is a very dainty 
animal. It is a fastidious epicure in its way, and its 
repast must be carefully prepared or it will not touch 
it. The part on which the leech is to be applied must 
be nicely cleansed and freed from hair. Not only 
must dust and dirt be removed, but the acidity of the 
skin from perspiration and the presence of any strong 
perfume are to be avoided. When the skin is greasy, 
it is to be washed with soap and warm water, in which 
a little borax has been dissolved. If the leech be 
applied about the head, the hair of the part must be 
shaved off, and the surrounding hair cut to prevent 
irritation or festering of the leech-bites. The precau- 
tion of cleansing well the part to which the leech is 
applied, by warm water and soap, and then with clean 
hot water, and drying it so that neither taste, smell, 



536 HOW TO ADMINISTER MEDICINES TO THE SICK. 

nor dampness remains, is not to be overlooked; for, if 
neglected, the delicate leech will turn with loathing 
from his task, and all attempts to coax him back will 
be vain, much to the annoyance of both patient and 
nurse. 



HOW TO MAKE THE LEECH TAKE HOLD. 

If there be a number of leeches to be applied, they 
are best placed in a tumbler or wineglass, which is 
then inverted over the part, thus preventing them from 
crawling about. Sometimes it happens that they will 
disregard their professional duties, and, instead of 
going to work, will wander about the sides of the glass, 
and exhaust the patience of the sufferer and the nurse 
by their dilatory proceedings. This loss of time and 
patience may be prevented by rinsing the glass with 
vinegar and water, and wiping it lightly before put- 
ting the leeches in. The acid coating on the inner 
surface of the glass will not only prevent them from 
sticking to it, but act as an irritant to excite them to 
bite. A novel and quaint way of applying leeches 
is said to be in use by the peasantry of some parts of 
Europe. About one-third from the top of a sour 
apple is cut off, and a smaller piece from the stem 
end. The inside is then scooped out, so as to form a 
kind of a cup. The lower end is then placed on the 
part to be leeched, the leeches thrown in, and the top 
piece held firmly on as a cover. The result is stated 
to be always satisfactory, the leeches showing a 
decided distaste for adhering to the walls of their 



HOW TO APPLY LEECHES. 537 

disagreeable prison. Another prompt and efficacious 
method of applying them is to hold a warm napkin 
in the hollow of the hand, and have the leeches 
dropped into it. They dislike dry warmth, and will, 
therefore, seize hold of the skin the instant they are 
applied to it, which should be of course immediately. 
They also dislike a cold surface; therefore, if the part 
to which they are applied feels cold, it must be warmed 
by holding on it for a moment a spongeful of warm 
water, and then drying. 

If these precautions have all been taken, and still 
the leeches will not take hold, apply a little warm 
sweetened milk to the part. If the leeches be slug- 
gish, immersing them for a few minutes in some beer 
will enliven them and excite them to bite. 



HOW TO HANDLE LEECHES. 

The nurse, unfamiliar with the leech, does not know 
how, and dreads very much to handle it. Now, in 
order to apply it, it must be handled; therefore, this 
repugnance has to be overcome. They can be taken 
up with a towel. Or, what is still better, they may be 
managed by tying a handkerchief loosely over the 
hand, for the freer use of the fingers. Under these 
circumstances, the most voracious leech, as has been 
wittily said, would no more attempt to fasten on the 
cloth than the nurse to bite the dining-room door in 
search of a dinner. The leech should be held towards 
the tail end, and never too tightly, for, if grasped too 
firmly, it will be more intent on getting away than on 



538 HOW TO ADMINISTER MEDICINES TO THE SICK. 

doing what is wanted of it. If you cannot tell their 
heads from their tails, follow the advice which has 
been given to " throw them upon a plate, and they will 
soon crawl about, and, like Little Bopeep's nock, carry 
their tails behind them." 

Sometimes it is difficult to get all the leeches to 
stay in the glass; as fast as one is put in, another will 
crawl out. To overcome this difficulty, cover the 
glass with a piece of paper twisted around the edge 
in the same manner as one would cover a jelly pot; 
then cut a small opening in the centre of this paper 
cover, drop the leeches through, and invert the glass, 
paper and all, on the spot to be leeched; then slip the 
paper from under, and hold the glass firmly over the 
place, so as not to admit any fresh air, until the leeches 
have all taken hold. When all are on, remove the 
glass, and leave them perfectly undisturbed. 



TO MAKE THE LEECHES WORK. 

Occasionally it will be noticed that one of the 
leeches is not working like its fellows. It will be seen 
to curl up and remain idle, as will be evident from the 
fact that it is not increasing in size nor presenting the 
appearance of sweating, such as will be observed in 
its more active co-laborers. Under these circum- 
stances, it should be gently lifted off and put for a 
few minutes in a glass of beer or a tumbler of cold 
water, to which a teaspoonful of vinegar has been 
added; then wipe it dry, and return it, by folding it 



HOW TO APPLY LEECHES. 539 

in a piece of soft rag, so as to allow only its head to 
protrude, and thus direct it by the fingers to its place. 
The leeches should not be grouped too close together, 
but permitted to attach themselves at a little distance 
apart. The leech must never be pulled off. It will 
drop off of its own accord so soon as it has taken its 
fill. Until then, it ought not to be disturbed. The 
drawing of it violently away not only irritates the 
part, but may leave a portion of the jaw of the leech 
in the wound, which may excite severe and very painful 
inflammation. 



THE NUMBER OF LEECHES TO BE APPLIED. 

This varies with the nature of the affection, the 
strength and age of the patient, and the locality 
leeched. From one to several dozens are employed, 
according to circumstances. Children can rarely bear 
more than from three to six. In the case of an infant, 
a single leech has been followed by dangerous depres- 
sion of the system. To very young children, leeches 
should be applied with caution. In adults, a common 
number is from fifteen to twenty at one time. 



HOW TO LEECH NEAR THE EYE OR MOXJTH. 

A leech is often ordered near the eye, and patients 
not unfrequently tremble at the idea of having so 
bloodthirsty a little animal near so delicate an organ. 
This nervous feeling may be overcome, and the eye 
perfectly protected, by gumming over it a piece of 



540 HOW TO ADMINISTER MEDICINES TO THE SICK. 

tissue paper, and making a hole through it where the 
leech is to suck. 

"When the leech is applied near the mouth, or to the 
lips or gums, a natural fear arises lest it should slip 
down the throat. Although really no harm would 
result from the mishap, further than the taking of a 
dose of oil or an emetic of salt and mustard, for the 
leech could not adhere to the coats of the stomach, 
yet, in order to spare the feelings of the patient, it is 
important to make such a sickening accident impos- 
sible. This is readily done by placing a piece of card 
over the teeth. If the gum is to be leeched, the card 
is to be perforated over the spot. 

PARTS NOT TO BE LEECHED. 

The application of leeches to the face or neck is to 
be avoided, if possible. This is especially the case 
with a female patient, for the bites of the animals may 
be followed by little scars. 

Leeches are never to be applied to the eyelids nor 
other parts where there is loose tissue under the skin. 
They should be put around an inflamed part, and 
never in the centre or focus of the inflammation. 

THE REMOVAL OF THE LEECHES. 

The leeches, as we have said, should never be 
detached, but suffered to fall off when they have 
satisfied themselves. "When this time approaches, 
they must be carefully watched to prevent their fall- 
ing in among the bedclothes, an accident which 



HOW TO APPLY LEECHES. 



541 



would soil the bed greatly. A slight motion will show 
that they are near the end of their repast, when they 
can readily be secured as they fall. They are at once 
to be thrown into a dark-colored wine or porter bottle, 
half full of water, and a cork put in, for there is air 
enough in the bottle for their support. After two- 
thirds of them are off, the remainder can easily be 
detached by dropping a grain or two of salt on their 
heads. As soon as the bleeding has ceased, sprinkle 
the part with some powdered starch, and coyer with a 
piece of soft^ dry cloth. 

TO PROMOTE THE BLEEDING. 

Sometimes it is desired to continue the bleeding 
after the removal of the leeches. This can be accom- 
plished by sponging the part with warm water, and 
covering it by flannel cloths, which have been 
immersed in hot water. These hot, moist cloths are 
to be kept on, and renewed during half an hour or 
an hour or two, according to the amount of blood 
desired. 



TO STOP THE BLEEDING. 

Sometimes the bleeding is too profuse, and it is 
desirable to check it. This is especially apt to be 
the case with children, with whom the application of 
leeches is, in some instances, followed by copious and 
even alarming loss of blood. 

One of the best applications in these cases is a 
piece of dry tinder, bound with some pressure upon 



542 HOW TO ADMINISTER MEDICINES TO THE SICK. 

the part. Or, cover the part with a piece of lint, 
which is to be left on until the blood has coagulated 
into a kind of crust. Or, a piece of cotton- wool or of 
a beaver hat may be bound firmly on the part. Or, a 
cobweb spread upon it. The application of cold water 
and pressure are usually sufficient. "What is better, 
however, is to wet some lint in a mixture of vinegar 
and water, or in a strong solution of alum. In severe 
cases, which rarely occur, these means failing, Mon- 
sell's solution of iron is to be obtained from the drug- 
gist and applied on lint, or a stick of lunar caustic is 
to be sharpened to a fine point and inserted into the 
little wound for a moment. 



THE AMOUNT OF BLOOb TAKEN. 

The best foreign leeches will draw, each, from half 
to three-fourths of an ounce of blood. The American 
leech not more than one-fourth as much. This differ- 
ence is to be borne in mind in choosing and applying 
the leeches. 



HOW TO TAKE CARE OF THE LEECHES. 

After the leeches have remained awhile in the water 
in a dark place, in which they were first thrown as di- 
rected, the water should be changed. Eain- water is to 
be preferred. The water is to be changed once or twice 
a day so long as it remains tinged with any blood. 
The dead leeches are to be carefully removed, for 
their putrefaction would soon destroy the rest. A 



CARE OF LEECHES. 543 

little pond mud or common earth is then to be thrown 
into the water, into which the leech will burrow and 
cleanse itself, in accordance with the instincts of its 
nature, far more effectively than any art can do it. 
Leeches should never be squeezed nor placed upon 
salt, disgusting and barbarous practices both, which 
injure or destroy the animals. 

A damp cellar is the best place to keep the leeches 
in. The water should be changed as often as once 
every week. 

DIRECTIONS FOR CUPPING. 

There are two kinds of cupping. One is a method 
of bleeding, and requires the use of surgical instru- 
ments. It should, therefore, only be performed by the 
physician. The other consists not in abstracting 
blood, but in drawing it to the surface. It is, therefore, 
called dry cupping, in contradistinction to the other 
knowm as wet cupping. 

Dry cups are useful in rheumatic affections, and in 
various diseases of the brain and spinal cord, of the 
chest, and of the larger joints. A knowledge of the 
proper method of applying a dry cup is readily ac- 
quired, and but little practice is needed to do it well. 
An ordinary tumbler, or thick-rimmed jelly jar, or wine- 
glass, makes a good cupping-glass. Hold the glass 
inverted for a few moments over a flame, or immerse 
it in hot water and before it gets cool apply it upon 
the skin; or, what is better, take a little pellet of 
cotton or paper and wet it with alcohol, set it on fire 



544 HOW TO ADMINISTER MEDICINES TO THE SICK. 

and throw it in the glass, which then, in a moment, 
invert over the skin. There is no danger of the burn- 
ing pellet hurting the skin, as would at first be sup- 
posed. It is extinguished in a second, and causes 
absolutely no pain, if the rim of the glass be firmly- 
pressed into the skin. Allow the glass to remain on 
the part for a half hour or longer. The skin will be 
reddened and rise up into the interior of the glass. 

In order to remove the glass, press the skin down 
at one side of the edge so as to tilt the glass and let 
in the air at one spot, when it will easily come off. 

Cupping-glasses are now made, [and can] be had 
of the druggist, which are very convenient. They 
consist simply of a glass the top of which is covered 
with an India-rubber ball and the bottom open. In- 
dent with the finger this round rubber top, place the 
glass upon the skin, let go of the rubber, and the 
glass will adhere firmly, the skin rising up rapidly 
inside. 



DIRECTIONS FOR THE ADMINISTRATION OF 
INJECTIONS. 

Injections (or enemas or clyster as they are also 
called) are fluid medicines thrown into the bowels 
to accomplish one of several purposes. Their most 
frequent use is to act as purgatives and clear the lower 
bowel. They are also sometimes needed to check 
diarrhoea, when the fluid selected is an astringent ; and 
sometimes to stop bleeding from the bowels. In the 
latter cases the quantity injected is smaller than when 



THE USE OF CLYSTERS. 545 

a purgative effect is desired, and, of course, the medi- 
cine chosen is different. As every parent should be 
able to administer an injection to a child, and every 
nurse to a patient, we shall give some plain directions 
as to the manner of injecting and as to the solutions 
to be used for the purpose. 

In this connection we cannot do better than to 
quote the concise cautions of Prof. Gross in his work 
on surgery, which are stated in language intelligible 
to every reader. "The administration of injections is 
seldom performed with the care and attention which 
its importance demands. It is an operation which any 
one is supposed to be capable of executing, and the 
consequence is that it is generally done in a very 
awkward and bungling manner, without at all attain- 
ing the object for which it is undertaken. Simple as 
apparently it is, it requires an amount of skill which 
few of those who are intrusted with its performance 
possess. To answer the purpose for which it is 
intended, the injection should, in the first place, be 
accurately adapted, by its quantity and quality, to the 
capacity and tolerance of the bowel ; and, in the 
second place, it should be administered in such a 
manner as not to pain, irritate, or injure the parts. 
"Whatever may be the object of the enema, whether 
purgative, stimulant, astringent, or anodyne, no air is 
to be introduced with it, as this is always produc- 
tive of pain, and frequently completely frustrates the 
design of the operation. When it is desired to 
retain the injection for some time, and the bowel is 
exquisitely irritable, manifesting a constant inclina- 

35 



546 HOW TO ADMINISTER MEDICINES TO THE SICK. 

tion to throw off its contents, the end may sometimes 
be attained by the pressure of a warm cloth against 
the fundament. When the patient finds it necessary 
to employ injections habitually, a self-injecting in- 
strument, capable of holding a pint, and furnished 
with a long, curved nozzle, answers an excellent 
purpose, and may be used by the patient in the re- 
cumbent or semi-erect posture, as he may prefer." 

The best instrument is the hand-ball or self-acting 
syringe. It is to be preferred to any of the piston 
syringes. It consists of two rubber tubes connected 
in the middle by a ball or sac of rubber. The 
arrangement of valves is such that the fluid can only 
pass into the ball from one side through one tube, and 
only out on the other through the other tube. The 
free end of the tube, which conducts the fluid into the 
ball, is placed in the solution to be injected; then, by 
grasping the ball, compressing and relaxing it, the 
water is drawn into this sac, and thence pressed out 
through the other tube, the end of which is placed in 
the bowel. The advantage of this arrangement is that 
it is not necessary ever to take out and reintroduce 
the nozzle, in order to refill the syringe, as is the case 
with a piston syringe; for a continuous stream is 
obtained from the basin to the bowel. Neither is 
there any danger of wounding the bowel, which acci- 
dent is liable to occur from the introduction of the long, 
slender nozzle, attached to the large metal or hard 
rubber chamber of the old-fashioned syringe. 

The amount of fluid proper for a purgative injection 
is a pint for an adult; for a young person, half a pint; 



RECEIPTS FOR CLYSTERS. 



547 



for a child, a gill; and for an infant, a wineglassful, 
or half a gill. When the injection is employed to 
relieve pain, not more than one or two tablespoonsful 
should be thrown into the bowel, by means of a small 
syringe. The injection should be warm, and should 
not be given when the patient is in a perspiration. 

"We append a few receipts for common purgative 
and anodyne injections. 



A simple Purgative Injection. 



Take of— 

Common salt, 

Molasses, each a tablespoonful. 
Warm water, a pint. Dissolve. 
A small piece of soap may be added with advantage. 



This is the proper quantity for an adult; for a child 
one-fourth, and an infant one-eighth of this, as we 
have explained. 

Soap Injection. 



Take of— 








Yellow soap, 


a, quarter of a 


pound. 




Boiling water 


a pint. 






Cut the soap up 


into shavings, pour the 


boiling water 


over, and beat up 


till dissolved, 


and then, when suffi- 


ciently cool, use. 









Castor-oil Injection. 



Take of— 

Castor oil, a. wineglassful. 

White starch, a teaspoonful. 
Rub the oil gradually into the starch, and add a pint 
of soap and water, or of thin gruel. 



54:8 : 


HOW TO ADMINISTER MEDICINES TO THE 

Turpentine Injection. 


SICK. 




Take of— - 

Oil of turpentine, a teaspoonful. 
Beat up with the yelk of an egg, and add half a pint 
of thin gruel. 






Soothing Injection. 






Scrape up half a pound of the roots of Marshmallow. 
Simmer in a quart of water until reduced to a pint. 






Anodyne Injection. 






Take of— 

Laudanum, thirty to forty drops. 
Warm milk (or mucilage), one or two tablespoons- 
ful. 




This is the proper dose for an adult. 

For receipts for nutritious injections, see page 514. 

THE DOSES OF THE MORE COMMON MEDICINES. 

"We consider it important that the mother and nurse 
should be familiar with the doses of those medicines 
which are in general use. "With this information many 
accidents would be avoided. We have more than 
once In our practice been startled by the ignorance of 
the doses of common and powerful medicines dis- 
played by those otherwise well informed. We have 
known mothers to have a very exaggerated notion of 
the dose of laudanum or of paregoric proper for a 
child. Many children, through ignorance, are danger- 



A RULE TO BE REMEMBERED. 549 

ously dosed with active drugs. Fatal results would 
doubtless be of more frequent occurrence, were it not 
for the fact that druggists are very apt to furnish 
families with a much weaker preparation than the 
officinal compounds which they use in prescriptions. 



KO¥ TO TELL THE DOSE FOR A CHILD. 

The doses which we give below are for adults. For 
children, the doses must be diminished in the proportion 
of the age to the age increased by 12. 

For example : if the child be two years of age, we 
diminish the adult dose by \ for the age of the child 
(2), divided by the age of the child plus 12=-—^=}. 

Again, if the child be six years of age, we dimmish 
the adult dose by J, for by dividing the age of the child 
by the age of the child plus 12, we have -1_.=^-=|. 

At two years of age, therefore, the child's dose of 
medicine is one-seventh of the adult's ; at six years of 
age, one-third. 

This rule for ascertaining the dose of medicine for 
a child at any age from the dose for an adult, is one 
easily remembered, and we trust it will be committed 
to memory by every reader of this book. 

In the list given below, we mention only those 
preparations which are familiar to every household. 
It is, of course, useless to give the doses of those drugs 
which are unknown to people in general, and which 
are only administered in the form of prescriptions. 
The dose of every prescription should be upon the 
bottle, package, or box, and Jcept there. No prescription 



550 HOW TO ADMINISTER MEDICINES TO THE SICK. 

without a label should be permitted to remain in the 
house. 

DOSES FOR ADULTS. 

Black drop, 5 to 10 drops. 

Blue mass, 2 to 4 grains. 

Bromide of potassium, 15 to 30 grains. 

Calomel, 2 to 10 grains. 

Compound cathartic pills, 1 to 3. 

Castor oil, one to two tablespoonsful. 

Cod-liver oil, a dessertspoonful to a tablespoonful. 

Coxe's hive syrup, 10 drops to a teaspoonful. 

Cream of tartar, one to two teaspoonsful. 

Donovan's solution (of arsenic and iodine), 5 to 15 

drops. 
Dover's powder, 5 to 10 grains. 
Ergot, the powder, 20 grains. 

" the wine, a teaspoonful. 

" fluid extract, 20 to 30 drops. 
Fowler's solution of arsenic, 3 to 15 drops. 
Gentian, powder, 10 to 30 grains. 

" compound tincture, one to two teaspoonsful. 
Ginger, tincture, 10 drops to a teaspoonful. 

" powder, 10 to 20 grains. 
Gray powder, 2 to 20 grains. 
Hoffman's anodyne, one to two teaspoonsful. 
Huxham's tincture of bark, a teaspoonful to a table- 
spoonful. 
Ipecacuanha, powder, 1 to 2 grains (as an emetic, 15 
to 20 grains). 



DOSES FOR ADULTS. 551 

Ipecacuanha, syrup, 5 to 20 drops (as an emetic, one 

to two teaspoonsful). 
Iodide of potassium, 2 to 10 grains. 
Iron, syrup of iodide, 15 to 30 drops. 
Jalap, 5 to 15 grains. 

" compound powder of, 10 to 20 grains. 
Laudanum, 15 to 25 drops. 
LugoPs solution (of iodine), 3 to 10 drops. 
Magnesia, a teaspoonful. 
Morphia, y 1 ^ to \ grain. 
Muriatic tincture of iron, 10 to 20 drops. 
Paregoric, a teaspoonful to a tablespoonful. 
Peppermint, essence of, 10 to 40 drops. 
Podophyllin, \ to 1 grain. 
Quinine, 2 to 5 grains. 
Rhubarb, 5 to 20 grains. 

" syrup, one to two teaspoonsful. 
Santonin, 2 to .3 grains. 

Sarsaparilla, compound syrup, tablespoonful. 
Senna, 30 to 60 grains. 
Spirits of mindererus, tablespoonful. 
Squills, powder, 1 grain. 

" syrup, teaspoonful. 
Sweet spirits of nitre, 10 drops to teaspoonful. 
Tartar emetic, \ to 1 grain (emetic, 1 to 2 grains). 
Turpentine, spirits of, 5 to 30 drops. 
Valerian, tincture of, teaspoonful. 
"Wild cherry, syrup, teaspoonful to tablespoonful. 
Wine of opium, dose same as that of laudanum. 

These are the doses for adults ; to find the dose for 
a child, apply the rule on page 549. 



552 HOW TO ADMINISTER MEDICINES TO THE SICK. 



HOW TO MEASURE MEDICINES. 

A teaspoonful is equal to one fluidrachm. 

A dessertspoonful is equal to two fluidrachms. 

A tablespoonful is equal to half a fluidounce. 

A wineglassful is equal to two fluidounces. 

A gill mug or teacupful is equal to four fluidounces. 

A tumblerful is equal to eight fluidounces. 

Consequently, 
A pint (16 fluidounces) contains two tumblersful, or 

eight wineglassesful. 
A half pint (8 fluidounces) contains one tumblerful, 

or four wineglassesful. 
A gill (4 fluidounces) contains two wineglassesful, or 

eight tablespoonsful. 
A half gill (2 fluidounces) contains a wineglassful, or 
four tablespoonsful. 

The medicine glass, described on page 426, is the 
safest and most accurate measure for medicines. 

Dropping Medicines. — The size of the drop of differ- 
ent liquids depends upon the character of the liquid, 
the rapidity with which it is dropped, and the shape 
and size of the mouth of the bottle from which it is 
dropped. 

We give below a 



TABLES OF MEASURES AND WEIGHTS. 



553 



TABLE SHOWING THE NUMBER OF DROPS OF DIFFERENT 
MEDICINES IN A TEASPOONFUL (FLUIDRACHM). 

DROPS. 

Laudanum 120 

Wine of opium 78 

Fowler's solution of arsenic . . .57 
Muriatic tincture of iron . . . 132 

Water 48 

Water of ammonia, strong . . .54 
" " weak ... 45 

Druggists dispense fluid medicines by means of the 

wine measure. This measure we give below, with the 

signs annexed: — 

Apothecaries' or Wine Measure. 



The gallon, G 
The pint 
The nuidounce 
The fluidrachm 



contains 



eight pints, 0. 
sixteen fluidounces, fr- 
eight nuidrachms, f3 . 
sixty minims, n^. 



Druggists dispense solid measures by means of 
Troy weight, which we give below, with the signs an- 
nexed : — 



Table of Apothecaries' Weight. 



The pound, Ife 
The ounce 
The drachm 
The scruple 



contains 



twelve ounces, 3. 
eight drachms, 3* 
three scruples, £. 
twenty grains, gr. 



Physicians, in writing their prescriptions, use these 
tables for ordering the quantities of the different 



554: HOW TO ADMINISTER MEDICINES TO THE SICK. 

articles prescribed, employing for this purpose the 
signs we have annexed to the above tables. They 
decide first upon the medicines to be given in the 
prescription, then upon the dose of each they wish to 
administer, and then upon the number of doses in the 
prescription, which number depends upon the length 
of time the prescription is intended to last, and then, 
in order to make up the recipe, they multiply the dose 
of each ingredient by the number of doses in the whole 
mixture. For instance, suppose the doctor wishes to 
give a febrifuge, and decides upon administering tartar 
emetic, sweet spirits of nitre, spirits of mindererus, and 
water. He concludes to give of tartar emetic ^ of a 
grain; of sweet spirits of nitre, J teaspoonful Q flui- 
drachm); of spirits of mindererus, a teaspoonful (1 
fluidrachm); in about three teaspoon sful (3 flui- 
drachms) of water. He wishes to give three doses a 
day for four days, consequently he wants his mixture 
to contain 12 doses in all. He therefore multiplies 
each of the above doses by 12, and obtains the follow- 
ing prescription: — 

B. Tartar emetic, 1 gr. 

Sweet spirits of nitre, f 3iv. 

Spirits of mindererus, f giss. 

Water, fliv. M. 

Directions — A tablespoonful three times a day. 

These calculations are all made mentally, and, by 
practice, with great rapidity. Most physicians use 
in their prescriptions the Latin names of the drugs, 
although some now employ altogether the English 
names. 



HOURS FOR GIVING MEDICINES. 555 



THE TIME OF THE DAY TO ADMINISTER MEDICINES. 

It is important that the rest of the patient shall not 
be disturbed at night. The giving of purgative medi- 
cines should therefore be so timed that their operation 
may be expected during the day. When the bowels 
are not irritable, and when the medicine is not a very 
powerful purgative, this may be accomplished by 
giving the dose late at night, just before sleeping; 
otherwise the best time is early in the morning. 

Emetics are preferably administered in the evening, 
for their action is apt to be followed by drowsiness 
and a tendency to perspiration, which it is desirable 
to promote. 

Medicines designed to produce perspiration, like 
sweet spirits of nitre, spirits of mindererus, hot 
drinks, etc., should not be given on a full stomach, 
but only after the work of digestion is over. While 
the stomach is occupied with the food in . it, the 
nervous force of the body is directed there, and the 
glands of the skin are less disposed to action. 

In some cases, the proper hours for giving the doses 
of medicine vary with the stage of the disease. 
Thus a dose of opium will increase the fever, add to 
the thirst and restlessness, or give tranquillity and 
sleep, according to the temperature of the body at the 
time of the administration. For this reason, when an 
evening dose of opium is ordered by the physician in 
cases of fever, the best time for administering it is 
very late in the evening or one or two o'clock in the 



55(5 HOW TO ADMINISTER MEDICINES TO THE SICK. 

morning, when the skin is becoming less hot and more 
moist. 

The intervals between each dose of medicine will be 
regulated by the physician in charge. It of course 
varies with the nature of the remedy, the object 
sought to be accomplished, the nature of the disease, 
and the condition of the patient. The effects of quick 
stimulants, like spirits of ammonia and Hoffman's ano- 
dyne, are very fleeting, and must, therefore, in cases of 
great prostration, be repeated at short intervals. So, 
also, medicines which act upon the skin to produce per- 
spiration, must be given sufficiently often not to let the 
impression they have made pass away before renewal. 
In this connection it should be recollected that cer- 
tain medicines, prominently mercury and lead, have 
the power of accumulating in the system when ad- 
ministered in small doses frequently repeated. This 
danger of accumulation must be guarded against. It 
ought to be known, also, that the various preparations 
of opium and morphia rarely produce their full effect 
before three-quarters of an hour after administration. 
Before repeating a dose, therefore, this time should be 
allowed to elapse, in order that the complete effect of 
the previous dose may be known. 

Constitutional peculiarities in regard to the effects of 
medicines are frequently met with, and often occasion 
much confusion and alarm. Some persons, for in- 
stance, cannot take opium nor any of the salts of 
morphia. This anodyne, instead of acting upon them 
as it does upon others, produces a state of excitement 
and abnormal wakefulness. In those peculiarly sus- 



INDIVIDUAL IDIOSYNCRASIES. 557 

ceptible to the action of mercury, the external use of 
blue ointment has been known to produce salivation, 
although but one application was made, and that of a 
very small quantity. On the contrary, there are those 
upon whom it is difficult to produce the full effects of 
this drug, in however large or frequently repeated 
doses it may be given. Powdered ipecacuanha occa- 
sions in quite a number of people attacks of short- 
ness of breath, asthmatic seizures in fact. A case is 
related of a lady who could not take even a small dose 
of poivdered rhubarb without an erysipelatous redness 
immediately showing itself on the skin, and yet she 
could take the same drug in the form of a tea without 
injury. 

These constitutional peculiarities are not confined 
to medicines, they are met with in regard to common 
articles of food. The venerable professor of the 
practice of medicine in the Jefferson Medical College, 
Dr. Dickson, says on this topic: "The most innocent, 
nay, the choicest articles of food, are injurious to some 
persons by an obscure and inexplicable unadaptedness. 
I can add to the great number of such, which may be 
found in the books, a very remarkable instance. I 
knew a lady who suffered invariably from oppressive 
nausea, and frequently vomiting also, if she partook 
of anything containing the smallest portion of egg 
mingled with it in any way. There was in this case, 
too, an almost incredible acuteness of perception, 
forming an instinctive safeguard against any mistake; 
she was aware of the presence of an egg, whether 
cooked or raw, and even became restless and uneasy 



55S HOW TO ADMINISTER MEDICINES TO THE SICK. 

when an unbroken egg was brought near her. The 
article, being easy of concealment, was often experi- 
mented with, and the result always the same; she was 
rendered uncomfortable, became sick, and complained 
that she was annoyed by the smell and flavor until it 
was removed. It is possible that this instinctive 
revolt against articles injurious from constitutional 
peculiarity may not exist; nay, it is possible every 
one may have known such examples, indeed, that 
an individual may be specially fond of what is 
specially hurtful to him; and this should lead every 
one who labors under indigestion to inquiry and 
experiment, that he may discover and avoid the nox- 
ious food." A similar instance of dislike for eggs is 
mentioned by Donatus, who tells of a boy whose jaws 
swelled, whose face broke out in spots, and whose lips 
frothed, whenever he eat an egg. Mussels and some 
other forms of shell-fish are always poisonous to some 
people, although in general they are a harmless and 
healthful food. 

The odors of food or medicine, or certain powerful 
perfumes, produce in some individuals very peculiar 
and distressing symptoms. Pope Pius VII. had such 
an antipathy to musk, that on one occasion of pre- 
sentation, an individual of the company having been 
scented with that perfume, he was obliged to dismiss 
the party almost immediately. 

These peculiarities are not confined to individuals, 
they extend to large bodies of men, constituting na- 
tional idiosyncrasies. The people of the Orient, on 
account of their temperament, are able to bear with 



A NECESSARY CAUTION. 559 

comparative impunity larger amounts of alcoholic 
drinks, opium, and tobacco than Americans or Euro- 
peans. It has been said that the Chinese have a sus- 
ceptibility to opium, like wax to the seal. Although 
they use opium to excess, neither their intelligence 
nor physical stamina is apparently affected by it. So 
also the indolent Turk consumes enormous amounts 
of coffee, opium, and tobacco, and yet breaks down 
only exceptionally. Education and early habits, as 
well as climatic influences, give rise to these often 
very curious and extraordinary national peculiarities. 
The refined ancients regarded the flavor of citron 
with disgust, but deemed the odor of putrid fish so 
exquisite that they carried it about on their persons in 
caskets of onyx, as .a favorite perfume. The Arctic 
explorers all dwell upon the fondness shown by the 
Greenlanders for their train oil. Dr. Heberden men- 
tions a town in North America, where the spring- 
water is brackish. The inhabitants, when they visit 
neighboring localities with pure water, prefer to put 
salt with their tea, coffee, or punch, in order, as they 
say, " to make it taste as it should do." 

We have detailed at some length these constitu- 
tional peculiarities, in order to impress upon the mind 
of our reader one or two important lessons. If there 
be found in any particular case an extreme suscepti- 
bility to any particular remedy or article of food — 
avoid giving it, for this idiosyncrasy can rarely be 
safely combated. Again, a knowledge of the existence 
of constitutional peculiarities should lead people to be 
careful about drawing sweeping conclusions as to the 



560 HOW TO ADMINISTER MEDICINES TO THE SICK. 

effects of drugs and diet. It does- not follow that an 
article of food or medicine which is ordinarily found 
of benefit in a disease, cannot do harm in some cases 
of that disease; nor does it follow that because a 
substance disagrees with one man, that he is right in 
denouncing its use by all of his fellows. We hope 
the perusal of the pages we have just penned will, 
therefore, teach both caution and charity. 

Age and sex influence the doses and effects of 
medicines. Certain drugs are better borne by chil- 
dren than adults. Mercury is one of these. Calomel 
and gray powder can be given to children in doses 
almost as large as to adults. Opium, on the contrary, 
is badly borne by children, and all of its preparations 
should be administered cautiously to them. "Women, 
because of their more delicate susceptibilities and 
finer organizations, need smaller quantities of power- 
ful medicines than men. During the monthly periods, 
pregnancy, and nursing, this is especially true. At 
these times care must be exercised in the administra- 
tion of potent remedies. 

Habit has much to do with the operation of medi- 
cines. As a rule, the longer a drug is taken the less 
effect it has, and hence the necessity of increasing the 
dose in order to keep the patient under its influence. 
This rule is subject, however, to exceptions. Some 
purgatives, especially certain natural purgative min- 
eral waters, increase in their activity when their use 
is long continued. The same is true of lead, the 
constitution becoming more and more sensitive to it, 
instead of being reconciled to it by habit. Emetics 



CONDITIONS INFLUENCING SIZE OF DOSES. 561 

very generally increase in power by repetition. The 
more frequently antimony or ipecacuanha is given, the 
smaller, as a rule, will the dose need to be, to produce 
vomiting. Doubtless the mind has something to do 
with this, for, after an emetic has been given often, 
the sight of it, the mention or even the thought of 
it, is sometimes sufficient to produce sickness and 
vomiting. 

The strength of the patient is also to be considered 
in regulating the dose of a medicine. It is evident, 
that after a patient has been worn out by long suffer- 
ing, wakefulness, and fever, he cannot bear so strong a 
dose as at the commencement of his illness. The 
nature of the disease determines to some extent the 
action of a remedy. Thus in fevers emetics act very 
readily, while in nervous diseases they act more slowly 
and imperfectly. 

"When a limb is in whole or part paralyzed, great 
care must be taken in making use of any external 
remedy upon it. The vitality of the limb is then 
impaired, and the skin and flesh are very easily in- 
jured. A distinguished surgeon has published an 
account of a very interesting case in illustration of 
this principle. The arm of a person became palsied; 
upon keeping the limb, in consequence of a fracture, 
in a tub of warm grains for half an hour, the whole 
hand became blistered in a most alarming manner, and 
sloughs formed at the extremities of the fingers and 
underneath the nails, although the mixture in which 
the arm had been kept was previously ascertained by 
the other hand not to be too hot. A limb deprived of its 

36 



562 HOW TO ADMINISTER MEDICINES TO THE SICK. 

usual supply of nervous energy cannot, as this case 
illustrates, sustain a degree of heat which would not 
be at all prejudicial to a healthy member. In another 
case, in which one of the principal nerves of the arm 
had been divided by a surgeon for the relief of a pain- 
ful affection, the patient was incapable of washing in 
water at a temperature that was quite harmless to 
every healthy part, without blistering and inflaming 
the hand. Nurses having charge of paralyzed patients 
should bear these facts in mind, and be careful, in 
making any external applications to the diseased parts, 
to graduate the strength and the heat of the applica- 
tion accordingly. 

In closing this chapter on the manner of administer- 
ing and applying medicines, we may be pardoned the 
space necessary to allude to a curious old supersti- 
tion, according to which medicine was used upon the 
substance which had injured the patient, and not upon 
the patient himself. Thus, if a man were wounded 
with a sword, some sympathetic powder, as it was 
called, was sprinkled upon the weapon which had 
made the wound. The blade was then covered with 
ointment, and dressed two or three times a day. This 
superstitious practice is frequently alluded to by the 
poets ; for instance, Sir "Walter Scott, in the Lay of 
the Last Minstrel: — 

"But she has ta'en the broken lance, 
And wash'd it from the clotted gore, 
And salved the splinter o'er and o'er. 



SUPERSTITIOUS NOTIONS. 563 

William of Deloraine, in trance, 
Whene'er she turn'd it round and round, 
Twisted, as if she galled his wound ; 

Then to her maidens she did say, 
That he should be whole man and sound. " 

So also Dryden, in his Enchanted Island: — 

"Anoint the sword which pierced him with this 
Weapon salve, and wrap it close from air, 
Till I have time to visit it again." 

Again, in representing Miranda entering with 
Hippolite's sword wrapt up, the poet records the 
following conversation : — 

Hip. O my wounds pain me. (She unwraps the sword.) 

Mir. I am come to ease you. 

Hip. Alas, I feel the cold air come to me ; 

My wound shoots worse than ever. 
Mir. Does it still grieve you? (She wipes and anoints the sword.) 

Hip. Now, methinks, there's something laid just upon it. 
Mir. Do you find no ease ? 
Hip. Yes, yes ; upon the sudden all this pain 

Is leaving me. Sweet heaven, how am I eased ! 

Belief in this method of treatment by proxy has 
now few disciples. The superstition has died out, 
although others, scarcely less absurd, survive. In the 
language of Lord Bacon, "witches and impostors have 
always held a competition with physicians." 




CHAPTEE V. 

ACCIDENTS IN THE SICK-ROOM. 



CONTENTS. 



Fainting ; How to ward off impending fainting — Shivering — Vomiting — Con- 
vulsions or fits — Delirium — Words uttered during delirium. 




HERB are various casualties incident to the 
sick-room, which deserve at our hands a few 



words of monition and instruction. 



FAINTING 

Is an alarming and sometimes a dangerous occurrence. 
A patient exhausted by disease may be unable to rally 
from a faint ; the heart, having ceased to act, may not 
resume its pulsations. Hence, the caution which 
should be impressed upon all nurses never to allow a 
feeble patient to rise suddenly in bed, for sudden 
rising is very apt to cause fainting. Hence, also, the 
importance, in very weak states of the system (par- 
ticularly after a loss of blood after childbirth, and 
after there has been a great drain upon the system, as 
in cholera, diarrhoea, dropsy, and large abscesses), to 
carefully heed the directions of the medical attendant 
not to allow the patient to rise at all, for any purpose. 

Many deaths occur from a disregard of this caution, 
( 564 ) 



TO WARD OFF IMPENDING FAINTING. 565 

frequently given by the doctor, but frequently unheeded 
by the nurse, because of ignorance of the risk incurred. 
The greater the debility the greater the danger from 
fainting, and the greater also the tendency to faint. 

To ward off an impending fainting fit, give a cup 
of warm tea, with a teaspoonful or two of brandy, or 
a few drops of aromatic spirits of ammonia. This 
is better than plain brandy and water, for the aroma 
of the tea adds to the stimulant effect. In cases of 
weak patients suffering from diarrhoea, or to whom 
laxative medicines have been given, it is well imme- 
diately after each operation from the bowels to give a 
small cup of tea, or preferably beef-tea. This replaces 
the fluid which has been drained from the system, the 
loss of which alone, without some such precaution, may 
induce fainting. The late distinguished physician and 
physiologist, Dr. Marshall Hall, laid great stress upon 
this precaution whenever it was necessary to purge a 
weak patient. 

The remedy for fainting is to lay the person flat on 
the floor or a hard mattress, to forcibly sprinkle the 
face with cold water, to loosen the dress about the 
throat, bosom, and waist, and to allow a free access 
of fresh air. More minute directions will be given for 
the treatment of fainting when we come to speak of 
surgical accidents and injuries. (See Index.) 

SHIVERING. 

Fainting is frequently ushered in by shivering, and 
a chill is often the first sign that the patient has taken 



566 ACCIDENTS IN THE SICK-ROOM. 

cold. A copious draft of some warm drink, the 
wrapping up of the patient warmly in bed, and the 
application of hot water to the feet, and of warm flan- 
nels to the stomach and armpits, constitute the proper 
treatment. 

When the chill is due to a cold just taken, a warm 
bath is of service, and may often avert serious conse- 
quences. 

VOMITING. 

Delicate persons and children are liable to attacks 
of vomiting at the outset of an illness. In such cases, 
nothing is to be done at first excepting to give a little 
water, in order to assist the stomach in its action. So 
soon as the retching subsides, the patient should lie 
down, and have warmth applied to the feet and legs, 
while the head is made cool. 

During illness, and particularly during convales- 
cence, vomiting frequently occurs in the sick-room in 
consequence of some errors or imprudences in food or 
exercise. The enfeebled stomach is often overtaxed 
under the demands made by the reawakened appetite. 
This is unwise. Too much food ought not to be taken 
at once. Nausea or vomiting after eating is an indi- 
cation that the food is improperly prepared, or that too 
much of it has been swallowed. The stomach can no 
more do its ordinary work during convalescence than 
the muscles can do theirs. A full meal is as prostrat- 
ing as a long walk. This fact is often overlooked, 
and, the appetite alone being consulted, harm results, 
the least of which is the rejection of the contents of 



VOMITING AND ITS TREATMENT. 567 

the stomach. The remedy in these cases is to eat less, 
but oftener. 

When the vomiting is persistent, of course the 
attention of the doctor will be called thereto. It often 
is the first sign that the brain is becoming affected in 
the course of the disease. 

It is always safe to treat vomiting by getting the 
patient to swallow small pieces of ice, and applying 
mustard poultices to the feet. The patient should lie 
down, not sit or stand. Brandy, whiskey, ammonia, 
and other irritating articles, should not be given, for 
they only add to the irritability of the already over- 
irritated stomach. A cupful of thin gruel rapidly 
swallowed will sometimes stop the retching. A table- 
spoonful, or, if this cannot be borne, a teaspoonful of 
iced lime-water and milk (equal parts) every quarter 
of an hour, is the best food. Broths cannot usually, 
» under these circumstances, be retained. 

CONVULSIONS OR FITS. 

We have spoken at some length of the signification 
of convulsions or fits in childhood (page 379). In an 
adult a fit is a more serious occurrence than in a child. 
While it lasts, prevent the patient from injuring him- 
self, and apply cold to the head and heat to the feet. 
The treatment of those diseases characterized by fits, 
as epilepsy, will occupy us hereafter. (See Index.) 



568 ACCIDENTS IK THE SICK-ROOM. 



DELIRIUM. 

The ravings and low mutterings of the sick justly 
excite both apprehension and sympathy. Here, unlike 
in fainting, the trouble is that there is too much blood 
circulating in the brain, or that the brain-structure is 
irritated by the presence of some poison in the circu- 
lating fluid. 

Delirium may take the form of low mutterings, and 
the patient seem as if in a disturbed dream, or he may 
be violently excited, even to a state of maniacal fury. 

The former condition, in which the delirium is of 
the passive kind, is met with in low fevers and other 
exhausting diseases. Bathing the head with a mixture 
of one part of good cider vinegar to six of water, or 
applying a mustard plaster to the nape of the neck, 
will be all that we need suggest to the nurse in this 
connection, for the attending physician will have charge 
of the case in this serious stage. 

In the active form of delirium, intelligent restraint 
is necessary to prevent the patient from doing himself 
great, perhaps fatal, injury. Inasmuch as this state of 
intense excitement may arise in the absence of the 
physician, every one should know the importance of 
gentle but firm and vigilant restraint. The most fear- 
ful consequences may result from the want of it, the 
patient in his insane fury throwing himself out of the 
window, or suddenly assaulting with fatal cunning and 
energy some friend whom he imagines his foe. In 
high delirium, when there is an attempt to get out of 



CARE OF THE DELIRIOUS PATIENT. 569 

the bed, the patient must be unhesitatingly and deter- 
minedly held in check. If necessary, the arms are to 
be tightly fastened to the sides by a sheet or large 
towel, and the feet and knees tied together. Feeble 
women and young children may readily be restrained 
by drawing the sleeves of the nightgown beyond the 
hands and tying them over the chest, while the knees 
and ankles are confined by a silk handkerchief passed 
around them. As has been said, " some people have 
a horror of seeing a beloved object thus manacled. 
But, let them depend upon it, it is the best thing and 
the kindest that can be done. They are afraid lest 
the restraint should still further excite the already 
over-excited brain. But this is false reasoning. The 
action going on in the brain is the same whether the 
patient fight against the restraint, or against the 
imaginary impediments to his free motion, which the 
disordered mind conjures up. Is it not better that he 
should exhaust himself thus than knock himself to 
pieces against the bedposts, or rise and do himself or 
others some fatal injury?" 

In these cases, the feet should be kept warm, and 
the head cold by the application of cloths wrung out in 
the coldest water which can be had, or by the use of 
ice-bladders or bags. Cool sponging of the limbs and 
body is always grateful and calmative in delirium. 



WORDS UTTERED DURING DELIRIUM. 

Before dismissing this subject of delirium, it may be 
well, in the words of another, to "caution timid wives 



570 ACCIDENTS IN THE SICK-ROOM. 

and relatives, and all whom it may concern, against 
the notion that whatever a patient may utter in the 
state of delirium must necessarily have occupied his 
waking thoughts. It is thought that the poor sufferer, 
in the vagaries of the half-poisoned brain, goes over 
again scenes in which he has once been an actor, and 
thus jealousies and heartburnings arise from what is 
but the chimera of a disturbed dream. If any wife be 
disposed to make herself uneasy at the 'wild expres- 
sions' of her delirious husband, or the contrary ; if any 
parent or minister of religion be shocked at the de- 
pravity of the sentiments uttered by their children, or 
the members of their flock, let them remember that 
the mind is turned, as it were, upside down, and that 
the very opposite of the natural disposition may exhibit 
itself in the ravings of delirium. It is, indeed, true 
that no expression can come out of the mouth the 
type or root of which has not had some habitation in 
the mind ; but who is so fortunate — innocent child or 
modest matron — as not to have seen or heard that 
which, although it may not have remained long enough 
to taint, has nevertheless left its mark upon the im- 
pressionable mind? Therefore, it would be both 
wrong and unjust to judge any one, man, woman, or 
child, by the ravings of delirium. Whatever is so 
heard should be at once dismissed from the mind and 
buried in oblivion, as so much 6 sound and fury, signi- 
fying nothing.' " 

The treatment of hemorrhages, of burns and scalds, 
and other casualties which may occur out of the sick- 



ACCIDENTS IN THE SICK-ROOM. 



571 



room as well as within, will receive our attention when 
we come to discuss surgical accidents and injuries. 

(The index will enable the reader to turn at once to 
the page on which these or any other subjects are dis- 
cussed.) 






CHAPTEE VI. 

NOTES AND MAXIMS ON NUESING. 

CONTENTS. 

Miscellaneous hints, suggestions, and rules on the practical duties of the 

nurse. 

|UE object in this chapter has been to collect a 
number of useful and tersely stated maxims, 
short sentences, and paragraphs, upon various subjects 
connected with the care of the sick. These we have 
jotted down from our own experience, and culled from 
our medical reading. 

Duties of the Nurse, — The first thing for the nurse 
to do, is to gain the good- will of the patient. With- 
out that, many of her efforts will fail of their object, 
and the comfort and consolation which she tenders will 
be shut out of the heart of the invalid. Cheerfulness 
and a ready willingness to do all and bear all for the 
sufferer's sake — for love of him, or, if that cannot be, 
for the love of God — are the first and among the great- 
est qualifications of a nurse. But let her beware how 
she " assumes a virtue if she have it not." The eyes 
of sickness are often very sharp, and they quickly de- 
( 5*2) 



SELECTED SENTENCES. 573 

tect any crack in the ring of the false metal which is 
offered to them as genuine. If a man or woman does 
not rise from a sick-bed with feelings of loving thank- 
fulness towards her who has tended him or her during 
illness, the nursing has not been well performed. 

Nightgowns for the very Sick. — A good plan it is to 
have two or three night-dresses prepared in the follow- 
ing manner. Let them be cut up the front, not the 
back, as some have recommended, and some tapes to 
secure the two sides sewn on. It will be found easy 
to pull off a dress so prepared, and all dragging upon 
the patient's limbs will be prevented. If he cannot 
be lifted up, the nightgown may be removed as he 
lies, and the patient may be drawn on to a fresh one 
ready open beside him. 

Visitors to the' Sick-room. — Florence Nightingale 
says to nurses, these are the visitors who do your 
patient harm. "When you hear him told : 1. That he 
has nothing the matter with him, and that he wants 
cheering ; 2. That he is committing suicide, and that 
he wants preventing ; 3. That he is the tool of some- 
body who makes use of him for a purpose ; 4. That 
he will listen to nobody, but is obstinately bent upon 
his own way; and 5. That he ought to be called to a 
sense of duty, and is flying in the face of Providence; 
then know that your patient is receiving all the injury 
that he can receive from a visitor. 

Rules for Nursing. — The following rules are useful 
for the guidance of the nurse: — 



574 NOTES AND MAXIMS ON NURSING. 

1. In relating what has happened in the intervals 
of the physician's visits, adhere strictly to the truth, 
conceal nothing, even by desire of the patient or 
friends. Nurses too frequently neglect some remedy, 
or some advice, and attempt to conceal the omission 
by an equivocation; or, on the other hand, give pro- 
hibited food or allow forbidden indulgences, without 
admitting the truth. However sagacious the physician 
may be, he can, in this way, be led into serious errors, 
and the patient thus made to suffer in the end. 

2. Follow as closely as possible the directions given 
for the patient's food, medicine, and treatment. If 
any deviation becomes absolutely necessary, be pre- 
pared to admit the fact. 

3. Maintain cheerfulness in speech and demeanor. 
Never be heard to say, "Oh, he is very bad," or, 
" That is a bad case." Always assume that suffering 
will soon be relieved, that recovery is confidently 
looked for, and that the means employed are the best 
possible; for this end, inspire hope, not dejection and 
despair. 

4. Never relate stories of other bad cases, or fatal 
results of diseases, and the like, in the hearing of the 
sick; nor talk of anything unpleasant in any one's 
affairs. 

5. Carefully preserve the sick-room of the right 
temperature, clean, and sweet. Put all wetted towels, 
bed or personal clothing not in use, and all slops and 
evacuations, at once out of the room. 

6. Watch the patient in sleep, to be sure nothing 



PRACTICAL RULES FOR NURSIKG. 575 

lies over the mouth or nostrils. Apply a foot- warmer 
as soon as the least cold is perceptible: 

7. Anticipate the time of giving food by ordering 
it to be ready. Cook nothing in the room. One 
exception may be allowed to this rule. In long- 
standing diseases and during convalescence, a patient 
is often both amused and benefited by preparing tea in 
his presence; the smell alone is refreshing, and will 
often excite an appetite for it. Generally, no food 
should be kept in the room ; but in diseases of debility 
great benefit is sometimes derived from a feeder full 
of beef-tea left at the patient's side, to be drunk at his 
will in the night, without the trouble of asking for it. 

8. Do nothing in a hurry or bustle ; make no noise. 
Never sit on the sick person's bed. Take care in 
moving about not to shake the bed. Do everything 
quietly, calmly, with decision and firmness. 

9. Avoid eating anything, such as onions, pickles, 
and the like, which gives the breath a bad smell. A 
foul breath is very disagreeable to persons in health, 
much more in sickness. 

The Requirements of the Sick-room. — To sum up the 
requirements of the sick-room, they are, proper tem- 
perature; ventilation; a constant supply of fresh air; 
scrupulous cleanliness of the person, the clothing, the 
bedding, the utensils, the room itself; watchfulness 
and tenderness ; a judicious diet ; proper regulation 
of light ; oversight of visitors ; punctuality and care 
in the administration and application of medicines: 
and for all these, the sick must be dependent upon the 



576 NOTES AND MAXIMS ON NURSING. 

nurse. "Who should be intrusted with this office? 
]STo one can hesitate to answer that women, in nearly 
all cases, make the best nurses. Happy is the patient 
who has mother, wife, sister, or daughter, who, to 
natural affection, adds good common-sense and bodily 
strength for the office. Such a one will not fail to 
learn from the experience of others, if not her own, 
all that can be taught to enable her to fulfil its duties 
with propriety and discretion. 

Time necessary for Cure. — Grave diseases, which 
have been long generating in the system, will take 
equal length of time to cure. Let the medicine be 
taken faithfully, the suitable dietary strictly adhered 
to, all remedial means carefully followed out, never 
deceiving the doctor, directly or indirectly; and, lastly, 
trust firmly in your God, who alone has the power to 
save you, and put into the minds of those employed 
to give medical relief the knowledge and skill neces- 
sary to prove to man His boundless love and power. 
j 

Sudden Death in Children. — In the great majority 
of instances when death suddenly befalls the infant or 
young child, it is an accident} it is not a necessary 
result of any disease from which it is suffering. 
Among the causes of this "accidental" death in 
sick children are: sudden noises, which startle; a ra- 
pid change of temperature, which chills the surface, 
though only for a moment; a rude awakening from 
sleep ; an over-hasty or over-full meal ; any sudden 
impression on the nervous system ; any hasty altera- 



USEFUL SUGGESTIONS. 577 

tion of posture; in short, any cause whatever, by 
which the process of breathing may be disturbed. 
Very weak adult patients sometimes die and are often 
seriously injured by the same causes. 

Causes of " no Appetite." — The absence of appetite 
in the patient is in many cases due to defect in cook- 
ing, to defect in choice of food, or to defect in choice 
of hours for taking food. Let every nurse inquire 
whether her patient's want of appetite may not be 
traced to one of these defects. 

Pure air is tasteless and free from all smell, but we 
easily know it, as it conveys unto us its freshness and 
its exhilarating sensations, making us feel, as we swal- 
low the delicious draft, that it is God's own sweet 
medicine, the luxurious healing cup which his own 
hand of Love has sent. Go, early in the morning, to 
the garret bedside of the poor sick, where the atmos- 
phere in the unventilated room is dense with the cor- 
rupting effluvia of filth and disease, and but a few 
seconds will suffice to prove the power that a vitiated 
atmosphere can exercise over the system; but go, 
again, on a summer evening, in the garden or by the 
seashore, and the offerings of the flowers, or the in- 
vigorating freshness of the breeze, will impress you at 
once with the fact that one is the fount of corrupting 
mortality in man's small decaying house, the other the 
gift of unsullied nature, springing from God's beauti- 
ful and mysterious laboratory of earth. 

37 



578 NOTES AND MAXIMS ON NURSING. 

"Place in your kitchen the mottoes, ' Waste not, want 
not,' and, 'Feed the poor.' A plate of nice hot dinner 
from the well-spread table ! — what a treat and restora- 
tive to the debilitated sick ! Have ever such a plate 
at your board: it is for God himself." — Mrs. Hardy. 

Care of the Dead. — "When death has darkened the 
household hearth, some chosen kind relative or sym- 
pathizing friend should take charge of the door-key 
of the room where the dead are lying, to prevent the 
indiscriminate intrusion of the idly curious or imper- 
tinent visitor, for it is not uncommon to find, in every 
class of society, persons who feel a morbid pleasure in 
looking at a corpse, and pleas are often pressed upon 
domestics to obtain this gratification, which almost 
precludes the possibility of refusal. But never, with- 
out very strong reasons against it, refuse the request 
of affection, to take a last look at the remains of the 
loved or respected. Let the nurse accompany the 
sufferer into the chamber of death, and make no at- 
tempt to check the fast-flowing tears of natural affec- 
tion ; there the oppressed and afflicted soul should 
be allowed for a while to remain unnoticed while it 
pours out its sorrows in unrestrained indulgence, thus 
obtaining a relief which nothing else for the time can 
bring. But if it be wrong to debar the survivors from 
entrance into the chamber of death, it is equally inju- 
dicious to press an invitation to visit it, and wrong 
even to propose it. Men, from having less intercourse 
than women with the sick, the dying, and the dead, are 
far more timid on these occasions, though the same 



MISCELLANEOUS HINTS. 579 

reasons may deter both from wishing to see those they 
love lying in the stiffened grasp of death. Affection 
has and wishes to retain in the memory a living image, 
warm with social life, and repels the idea of mingling 
this with the dark shadow of cold, unsympathizing clay. 

Amusement for the Sick. — A genial English nurse 
writes: "The lightest trifle may often turn the mind 
from its gloomy tendencies. "We once paid a visit to 
a very learned friend of ours, an eminent antiquary, 
whom we found in very depressed spirits, endeavoring 
to find relief in Layard's Nineveh, which he threw 
down immediately on our entrance, to inform us he 
did not think he should live long. "We proposed a 
game at cats' cradle previous to the catastrophe ! so at 
it we went, and in a very short time the undertaker 
had quite disappeared from the door." 

Children in the Sick-room. — Children are at all times 
improper inmates of a sick-room. The vitiated at- 
mosphere and the breath of disease are alike injurious 
to them. Their tender, unformed organs, ever liable, 
from their delicacy, to infection, may there imbibe the 
first impression of disease, that may lie dormant for 
years ; and when time has placed its seal of forgetful- 
ness on the dead, it may develop itself in some fatal 
disorder of which the origin cannot be traced. Again, 
the constant, fidgety, eager watchfulness of these in- 
nocent visitors is a sore disturber of the comfort, and 
a great trial to the patience of the sufferer, although 
affection often demands the visit as a solace. 



580 NOTES AND MAXIMS ON NURSING. 

Avoid Alarming the Sick. — A really conscientious 
medical man will always give the friends warning if 
there be danger, and until he has given that warning, 
caution should be observed not to create alarm in the 
patient ; for, as the body is weak, so generally are the 
nerves, and if the patient is put in train for a cure, 
it may be rendered wholly abortive by w r ant of judg- 
ment in divulging the probable peril, and thus cre- 
ating fever through excitement. 

The Feet of the SicJc. — In every kind of illness it is 
essential that the extremities, the feet especially, be 
kept warm. Of course, in a burning fever, they will 
be hot enough, and tepid sponging of them will be the 
most soothing thing you can do; but in nine cases out 
of ten, particularly if the illness has endured for any 
length of time, the feet have a tendency to become too 
cold. 

Care of the Head. — The head should be kept cool in 
all cases where the heat of the shin is above the natural 
standard. There must be no caps, handkerchiefs, or 
shawls wrapped about it. If the head be unusually 
hot, remove the bolster and pillows altogether, and 
supply their places with horsehair cushions or water- 
pillows. 

Breathing Air. — We know that invalids require 
tvarm air, but, as we have before stated, this air must 
be pure. If there be sick persons or habitual invalids 
in a house, there is greater necessity than under other 



FACTS O^ XURSIXG. 581 

circumstances for free ventilation, both for the purpose 
of giving the invalid pure air, and of removing his 
exhalations and preventing them from becoming a 
poison to himself or others. Any house or room, 
therefore, which is so situated as not to allow of free 
ventilation without admitting bad air or foul odors 
from the surrounding neighborhood, is not a fit resi- 
dence for persons in delicate health, and should as 
quickly as possible be abandoned. 

The Causes of Unclean Air. — The uncleanness of 
the air in dwellings arises from one or more of these 
conditions : Emanations from filth exterior to the 
dwelling, which, entering it, contaminates its air or 
water; filth within the dwelling, and operating in the 
same way; and insufficient outlet for the emanations 
from the bodies of the inmates. 

Neatness of Dress. — The dress of the nurse is not 
unimportant. In every case it should be simple, neat, 
and scrupulously clean. The material of which it is 
made should be soft and supple. Rustling silk and 
starched muslin are equally out of place in the sick- 
room; the first annoys the patient's ears, while the 
latter suggests that the nurse wants to be gadding 
abroad. 

JRespeci for Human Life. — A bad quality in a nurse 
is a want of respect for the sanctity of human life. We 
have sometimes been shocked by noticing an approach 
to this feeling in old, experienced city nurses. If the 



582 NOTES AND MAXIMS ON NURSING. 

nurse be given to make light of the result of illness; if 
she be in the habit of saying, "Ah, poor thing ! it's a 
good thing it's gone; it is out of its sufferings; better 
off where it is now," and so on: or, of saying, if the 
patient be poor, "Ah, poor creature! he's gone to a 
better place; it is a happy release for him," etc.; do not 
trust her. No doubt these expressions are all right, 
if the spirit which dictates them be all right. In a 
spiritual point of view, we may all rejoice when any 
one is released from suffering or misery. But the 
nurse often excites the suspicion by these remarks 
that she does not mean them in this light; but that 
she rejoices her trouble is at an end; that the fractious 
child is at last quiet; the enfeebled and querulous old 
man forever silent. 

Caution in Regard to Food, — Never give food to a 
hungry patient recovering from sickness, too finely 
minced. He is apt to bolt it, to save his weak jaws 
the trouble of mastication, and thus it will not be 
sufficiently mixed with the saliva for good digestion. 
An English physician says that almost the greatest 
agony he ever witnessed was caused by a neglect of 
this rule. A gentleman convalescing from an attack 
of inflammation of the lungs, feeling hungry, devoured 
at a late dinner a hearty meal of minced veal ; it was 
minced very small and well mixed with gravy, so as 
to glide down with ease without mastication. In the 
middle of the night the doctor was called to this 
person, who was said to be dying. He found him in 
too great pain to die, sitting by a large fire, shivering, 



NOTES AND MAXIMS. 583 

whilst great drops of cold sweat ran down his face 
and body, which was swathed in two or three blankets. 
The man was nearly pulseless, and his face wore an 
expression of the most intense suffering. The pain 
in the stomach and bowels was indeed excruciating. 
On learning the indiscretion of the preceding evening, 
the doctor administered an emetic, when the enemy, 
in a perfectly undigested state, was ejected from his 
stomach in immense quantities, and soon after the 
patient was put to bed in a warm perspiration, with a 
good full pulse and quite free from pain. 

Poultry for the Sick. — Iso poultry more than one 
year old is fit for an invalid, except to make broth, or 
to be boiled to a jelly. Its hard, stringy fibre is far 
more indigestible than tender mutton, beef, or even 
pork. The question, when do old hens cease to be 
chickens? is a curious and difficult one to answer. 
Clearly not until they have passed from the hands of 
the market people into our own. 

Sitting up all Night — When sitting up all night 
with the patient, the nurse should loosen her clothes, 
put on a flannel gown or common loose dress, remove 
all ligatures from the feet and legs, wear easy slippers 
and keep the feet raised on a chair, that the circula- 
tion may be less labored and that swelling of the legs 
may be prevented. In cases of contagious diseases, 
never remain, particularly at night, in a place where a 
current of air passes over the patient to yourself. In 
such cases not only is extreme cleanliness necessary 



584 NOTES AND MAXIMS ON NURSING. 

for the patient, but equally so for the nurse, clean- 
liness being one of the best of disinfectants. When 
life seems to be fast ebbing, it is usual for the whole 
household to wish to sit up; but unless immediate 
dissolution is apprehended, this should not be allowed ; 
nor ought- strangers nor unusual persons be admitted 
to the room of the dying, on the plea of the perfect 
insensibility of the sufferer, a plea which often does 
not repose upon fact, for who can tell the precise 
mental state at this last solemn moment ? 

Deportment about the Dying. — On the dying bed 
God is performing His last earthly work with man, 
and this solemn moment ought not to be profanely 
made a theatrical exhibition for the gratification of 
idle curiosity, or the display of morbid or fictitious 
feeling. All that is needed should be carried on with 
a gentle solemnity of manner, as if in the presence of 
the King of kings. The loved and the loving only 
should be allowed entrance into the room, for their 
naturally wished-for last fond look or parting kiss. 
He who is now so visibly unlocking the solemn gates 
of eternity is still the God of love, who feels for his 
suffering children when these sweet bands which 
gently linked together the survivors with the dead are 
loosened, and "Hew ho wept o'er Lazarus dead" still 
bears our griefs and carries our sorrows. Let this 
be our consolation. 

Mistaken Zeal. — "We have often heard it said, as a 
proof of devoted affection, that such a wife, mother, 



WORDS OF CAUTION. 585 

or daughter had been a week or ten days without 
changing her clothes or taking off her stays. While 
fully appreciating the feeling which prompted this 
forgetfulness of self, we feel in duty bound to censure 
such a practice most fully, and would ask the affec- 
tionate victim of these vigils if she would willingly 
open the window and throw away the last dollar on 
which the poor sufferer's resources depended, because 
she still had a few pennies in her pocket or had a 
friend to whom she could apply in the hour of need ? 
Yet this is what she is actually doing, for her know- 
ledge of the patient's habits, temper, and general 
wants makes her of more value to the sufferer than 
any one else. She should, therefore, preserve herself 
in a fit condition for the performance of her task, by 
economizing her strength, and using every endeavor 
for the restoration of her wearied energies. 

A Word of Caution as to Contagion. — Never go into 
a room in which there is a contagious disease, or a 
strong smell of sickness, when very hot, or in a state 
of perspiration, or fasting, or hungry. For, in the 
one case the seeds of disease are absorbed by the pores 
into the general system, and in the other they are im- 
bibed into it by the craving tissues of the stomach. 

Whispering in the Sick-room. — Never allow a 
whispered message to be brought to the sick-room 
door. Invalids have a kind of nervous apprehension 
that whatever is passing has reference to them, and 
they are consequently very suspicious of anything 



586 NOTES AND MAXIMS ON NURSING. 

that bears the least appearance of concealment; and 
as they rarely like to admit that they feel curious, 
they lie and brood over the mystery, to their great 
and needless injury. Everybody in the house should 
therefore be enjoined to communicate what they have 
to say in a clear and distinct manner. 

How to Drop Medicine into the Eye. — The nurse is 
often called upon to drop liquids into the eye — a 
nervous operation alike to patient and nurse. It is 
thus done: The patient throws his head very far 
backwards, and on one side, with the affected eye to 
the operator, who holds it open at the outer corner 
with the first and second fingers of the left hand. The 
patient then turns his eyeball inward, and the nurse 
drops from the bottle in her right hand, with a finger 
on its mouth, whatever quantity is required. If either 
party should be nervous as to excess in this matter, a 
very good plan is to cut a quill as for a toothpick, 
with an opening half-way up, into which drop the 
quantity and pour into the outer corner of the eye. 

Aid in Getting in and Out of Bed. — For getting in 
and out of bed, invalids, particularly heavy persons, 
should be provided with a pair of crutches, or thick 
walking-sticks, to rest upon, which will prove a much 
more efficient support than any woman's arm or aid 
can be, and will avoid entailing on the nurse that dis- 
tressing labor and strain upon the spine which in some 
cases has resulted in permanent disease for her. 



HOW TO BEAR PAIX. 587 

Influence of the Mind over the Sense of Pain. — An 
English surgeon of experience gives a few words of 
advice on this subject, illustrated by a pertinent anec- 
dote. Let all who have to suffer remember a few 
simple truths. When they give way, they add greatly 
to the distress and confusion of those who are with 
them, they very much hinder their own recovery, and, 
when the pain is over, reflect upon themselves for not 
having been braver. It is indeed wonderful what can 
be done, when a person makes up his mind to grin and 
bear it, as the soldiers say. Many have even borne up 
under slow cutting operations or accidents. A curi- 
ous instance, but a very instructive one, occurred 
some years ago, before chloroform was discovered. A 
large, well-made, healthy seaman was brought into 
the hospital with his leg so terribly crushed that it 
was necessary to take it off some distance above the 
knee. The surgeon said to him, " Jack, I am very 
sorry to have to tell you that the only thing which can 
be done with this unfortunate leg is to take it off; we 
cannot save it, you know we cannot splice it or fish it 
like a mast." 

" No," he replied, "I can see that; well, it must be 
done, it'll never be seaworthy any more. How long 
will it take doing it?" He was told only a very 
short time. "Oh, well," he said, 'cut the wreck 
adrift, and fit a timber one, I'll bear it." 

So the limb was taken off without one groan or one 
word of complaint. But as the house-surgeon was 
putting on a bandage, he accidentally pricked him 
with a pin, when he immediately cried out, " Hallo, 



588 NOTES AND MAXIMS ON NURSING. 

Mr. Surgeon, the point of that marling-spike's rather 
sharp, that's too bad." 

The surgeon said, " Why, Jack, how is this ? You 
bore haying your leg taken off like a brave fellow, as 
you are, without speaking one word, and now, when 
only the point of a pin touches you, you call out ?" 

"Ah, sir," he said, "don't you see, I made up my 
mind to have my leg cut off? I told you I'd bear it, 
but I made no bargain about the pin-sticking busi- 
ness." 

Duty of Amusing Sick Children.- — This duty is 
very properly strongly insisted upon by Dr. West in 
his work on Diseases of Children. No rules can, of 
course, be given how to accomplish this. The little 
one is to be soothed and pleased by every gentle way 
that a woman knows. If the child is a baby, sing 
some little tune to it; or, throwing a flannel wrapper 
round it, take it in the arms, and, as it is carried about 
the room, try to hush it to sleep. If the child is older, 
tell it stories to keep it quiet, and no one who really 
loves children will be at a loss in finding a story to 
tell. All children love to hear of what happened to 
grown people when they were young. Tell them of 
your own childhood, of what you saw and did when 
you were little, of the village where you played, of 
where you went to school, of your church and your 
clergyman. Or tell the fairy tales that you heard, 
and your mother before you, and her mother before 
her, in childhood — the tales of Goody Two Shoes, or 
Cinderella; Blue Beard, or Beauty and the Beast. 



A QUESTION WELL PUT. 589 

Fairy tales are not too foolish to be told, even although 
now we have so many good and useful books for 
children. Young people need amusement sometimes, 
and children cannot be always reading wise and use- 
ful and instructive books. The story which teaches 
nothing wrong; which does not lead a child to think 
lightly of what is good and right; which, in short, does 
no harm, is one that may be told to children without 
fear, though it may not impart any useful information. 
God himself has formed this world full not only of 
useful things, but of things that are beautiful, and 
which, so far as we can tell, answer no other end than 
this, that they are lovely to gaze upon, or sweet to 
smell, and that they give pleasure to man. 

Why must Children have Children's Diseases? — The 
following words of Florence Nightingale have much 
truth in them. We commend them to the attention 
of every nurse who has charge of sick children, and 
of every mother who desires to keep her own little 
ones well. "There are not a few popular questions 
in regard to which it is useful at times to ask a 
question or two ; for example, it is commonly thought 
that children must have what are commonly called 
' children's epidemics,' 'current contagions,' etc., in 
other words, that they are born to have measles, hoop- 
ing-cough, perhaps even scarlet fever, just as they are 
born to cut their teeth, if they live. Now, do tell us, 
why must a child have measles? Oh, because, you 
say, we cannot keep it from infection — other children 
have measles — and it must take them — and it is safer 



590 



NOTES AND MAXIMS ON NURSING. 



that it should. But why must other children have 
measles? And if they have, why must yours have 
them too? If you believed in and observed the laws 
for preserving the health of houses, which inculcate 
cleanliness, ventilation, whitewashing, and other means 
— and which, by the way, are laws — as implicitly as 
you believe in the popular opinion, for it is nothing 
more than opinion, that your child must have children's 
epidemics, don't you think that, upon the whole, your 
child would be more likely to escape altogether?" 



A Short Dressing- Gown. — Dr. Hope gives a useful 
hint on this subject. "When a patient is sufficiently 
well to sit up in bed, a shawl is very inconvenient. 
The ends dip into the food, and are constantly irri- 
tating the patient by getting on to the bit of work 
going on. Then, again, it must be either fastened so 
tightly around the body as to confine the arms, or, if 
they are used, it must be raised so that both they and 
the chest are exposed. Instead of this, a flannel 
jacket is strongly to be recommended, made very 
loose about the shoulders and arms, and to button 
from the neck down the front and at the wrists. The 
neck and wristbands should be lined with silk or other 
soft material, so as not to chafe the skin. Let there 
be two good pockets, one for the handkerchief, and the 
other for the spectacles, eye-glass, pencil, thimble, and 
other small things which are always going astray. The 
season of the year, the kind of room, and nature of the 
illness, will be a guide as to the warmth of the jacket. 



THE PEEILS OP BAD NURSING. 591 

This is quite a different thing from the common long 
dressing-gown used when a person is out of bed. If 
the jacket be made of new flannel, it should be well 
washed with hot water and soap before being made up, 
or the smell may be very offensive to a person confined 
to bed. To throw over the shoulders and arms of the 
patient when he is sitting up in bed for a little w^hile 
only and not using his hands, there is nothing equal in 
comfort and safety to the " invalid's wrap," described 
on page 433. 

Importance of Good Nursing. — The Massachusetts 
Sanitary Commission, in a recent report, wisely say, 
it is hardly necessary to commend the importance of 
good nursing in the cure of disease. Let a physician 
be ever so skilful, and prescribe his remedies with 
ever so much care and sagacity, if the nurse does not 
follow his directions, or if she neglects her duty, or 
performs it unskilfully or imperfectly, or with an im- 
proper disposition, the remedies will be unsuccessful, 
and the patient will suffer ; and perhaps life is lost as 
the consequence. On the other hand, let a physician 
of moderate capacity prescribe with ordinary skill, if 
his orders are carried into execution by a nurse who 
understands, loves, and conscientiously discharges her 
duty, the patient is relieved, and life is preserved as 
the consequence. It is thus that bad nursing often 
defeats the intention of the best medical advice, and 
good nursing often supplies the defects of bad advice. 
Cursing often does more to cure disease than the 
physician himself; and, in the prevention of disease 



592 NOTES AND MAXIMS ON NURSING. 

and in the promotion of health, it is of equal and even 
of greater importance. Many and many a life, which 
might have been saved, has been lost in the hands of 
quack nurses, as well as in those of quack doctors. 




CHAPTER VII. 

CARE OP THE INFIRM. 

CONTENTS. 

The care of the aged — The care of the insane — The care of the idiot — The 
care of the inebriate. 

K" our present chapter we shall confine ourselves 
to a few practical remarks in regard to the care 
of infirm persons, reserving what we have to say upon 
the treatment of the diseases of the aged, and of the 
mind, until we reach the Third Part of this volume, 
when we shall have to treat in detail of the principal 
maladies to which all ages and both sexes are subject. 




CARE OF THE AGED. 

As we have already written a chapter on the pre- 
vention of decrepitude (see page 285), we need not 
here say more upon the problem of retarding the 
advance of years. The watchful care of loving eyes 
and hands can do much towards preserving in the 
aged mental and physical health and activity, so that 
when nature at last succumbs, it may be said, in the 
words of the poet: — 

38 ( 593 ) 



594 CARE OF THE INFIRM. 

"Of no distemper, of no blast, he died ; 
But fell like autumn fruit that mellow'd long : 
E'en wonder' d at, because it falls no sooner. 
Fate seem'd to wind him up for fourscore years ; 
Yet freshly ran he on six winters more, 
Till, like a clock worn out with eating time, 
The wheels of weary life at last stood still." 

In the care of the aged, one of the first points of 
importance is to enforce regularity of habits in regard 
to sleeping. Fortunately, in most cases, this regu- 
larity is naturally preferred. Although old persons 
do not require as much sleep as the young, yet they 
should retire to bed early in the evening, not later 
than ten o'clock. The rest, warmth, and horizontal 
position they have in bed are very beneficial. The 
sleeplessness often complained of by old people is-, in 
some cases, a delusion. Unknown to themselves they 
sleep more or less, and are in this manner refreshed. 
It is said of an old patient of Dr. Day's, that she 
used to tell him, in most piteous tones, that all she 
required was sleep. How long it was since "nature's 
sweet restorer" had last visited her we are afraid to 
say; but calling upon her one afternoon, he found her 
lying on her bed, sleeping as soundly and comfortably 
as any old woman could wish to do. The noise of a 
person entering the room soon awoke her; she rubbed 
her eyes, looked up, and said, "all she wanted was 
sleep; she had not closed her eyes for a month, and 
that if he could not give her something to procure 
her sleep, she must infallibly die." 

It sometimes happens that old people, who complain 
at night that when they awake they cannot get to sleep 



CAKE OF THE AGED. 595 

again, derive benefit from having some light and 
favorite article of food at the bedside, of which to eat 
a little. It is said of Louis XVIII., whose "appetit 
cliarmant" has been much admired, that he always had 
a cold chicken placed beside his bed, in case hunger 
should prevent his slumbers. And we know of a hale 
old gentleman who has never for years gone to bed 
without having some food at hand. 

Warmth of the body is carefully to be preserved in 
the old. This object is to be accomplished by a pro- 
per selection and amount of clothing, and a regard to 
those principles which we have pointed out in our 
chapter on the subject (p. 120). There is a great loss 
of vitality of the skin in old age. This loss is the 
cause of many of the diseases of the old. Its effects 
are not only to be combated by judicious clothing, but 
also by attention to the climate. It is well known 
that the skin retains its vitality much longer in hot 
climates. This fact is of value to those old persons in 
feeble health whose means will permit of a change of 
climate. This was the practice of one of the most 
practical of all the nations who have ruled the world; 
for after a certain age the wealthy Romans changed 
their residence from Rome to Naples. Without going 
abroad, many might imitate the Romans in migrating 
to the south of our own native land. The advantages 
of the climate of Florida for this purpose are many, 
and should be more generally known. 

For general rules in regard to the diet and exercise 
of elderly people, we refer our reader to our remarks in 



596 CARE OF THE INFIRM. 

the chapter commencing on page 285. We will merely 
add a hint from the pen of Mrs. Hardy. 

" The old are subject to numerous infirmities, which, 
even though not accompanied by suffering, demand 
much attention. From incapacity to take exercise, 
the perspiratory discharges acquire an impurity which 
renders the greatest watchfulness imperatively neces- 
sary, not only to cleanse, but to keep dry, every part 
of the skin which is subject to moisture. When this 
is not properly attended to, sores and excoriations 
will ensue, which may end in wounds, that exhausted 
nature has no longer the power to heal, and thus 
suffering is induced, which may only terminate with 
existence itself. This point of cleanliness, however 
disagreeable to the patient, those having charge must 
maintain the right to see enforced. Better for them 
to submit to the harmless scolding of the patient, than, 
for 'peace sake? to permit him or her to continue in 
the offensive self-bath." 



CARE OF THE INSANE. 

The question whether insane persons are better 
treated at home or in asylums established for the 
purpose, is a difficult one to answer. That there is a 
wide-spread prejudice against insane asylums in the 
community, it is useless to deny. That this prejudice 
is now unfounded, it is, perhaps, equally useless to 
assert. The popular idea of an insane asylum is that 
of a prison where persons are needlessly and often 
cruelly deprived of their liberty. The prevalence of 



FALSE AND INJURIOUS NOTIONS. 597 

this idea is to be regretted, as it interferes with that 
early treatment of unhealthy mental symptoms which 
is so desirable, and which, in many cases, can best be 
carried on in a well-regulated asylum, where the over- 
sight of skilled physicians, the absence of all disturb- 
ing causes, the presence of various healthful means of 
amusement and exercise, and the generally wholesome 
mental atmosphere, are of great service in advancing 
recovery. 

An asylum for the insane is not a prison nor a house 
of correction; it is a hospital. The object of the 
detention of the inmates is no other than their cure. 
By all means, let legislative enactments throw every 
safeguard around the individual, to prevent these 
institutions from receiving or retaining those who are 
in good mental health. But, on the other hand, let 
those who have members of their family suffering 
from mental disease consider well the advantages of a 
hospital for the insane, and, before deciding to treat 
their loved ones at home, let them visit for themselves 
and examine into the working of the most accessible 
institution of this sort. 

In this connection we wish to quote, with approval, 
the language in a recent report of the Pennsylvania 
Hospital. ""While some cases get well at home, and 
do not require a removal from familiar scenes and 
associations, it must be acknowledged that for a very 
large proportion of all that occur, this separation is 
almost indispensable for securing a recovery. The 
Christian spirit of the age, and the labors of benevo- 
lent men and women in nearly every enlightened 



598 CARE OF THE INFIRM. 

country, have provided a class of institutions that 
offer advantages that can nowhere else be obtained 
for the great mass of the people. Insanity, then, 
being placed in the same category as other diseases, 
with the peculiarity that the most luxurious of homes, 
conjoined with the happiest surroundings, are not 
commonly the best places for its treatment, these 
institutions, thus provided from the necessities of the 
case, become real hospitals, and nothing else, just as 
much as the like provision made for treating fever, or 
any other forms of sickness. The attempt to bring 
these hospitals for the insane into disrepute, by ap- 
plying to them and those connected with them the 
offensive epithets that belong to a past generation, can 
have no justification, and is unworthy of any honorable 
man. The public should learn that it is really of 
importance that the terms used in reference to this 
disease, the institutions for its treatment, and those 
connected with them, should be such as are employed 
when speaking of the same persons or things in any 
other hospital, in a private mansion, a hotel, or a 
boarding-house. A room for the sick, or a parlor, or 
a hall in a hospital, should be so called, as much there 
as in any other structure; and a nurse or an attendant 
on the insane is as much a nurse or an attendant in a 
hospital as in a private house, and in a case of fever. 
So a proper degree of restraint is no more imprison- 
ment when used in a hospital than it is in a private 
family, no more so when applied to a case of insanity 
than in the delirium of fever; nor is that kindly inter- 
ference which prevents personal injury, soothes ex- 



THE "COTTAGE SYSTEM" FOE THE INSANE. 599 

citement, and protects others, any more reprehensible 
in the one case than in the other. The remedy which 
does all this, and aids in the recovery of the patient, 
should have a generous recognition." 

If, however, the objection to an asylum be an insu- 
perable one, or the expenses be too great to be met, it 
is better to send the patient from home. A change 
of scene, and a removal from the danger of that irrita- 
tion which is quite certain to be caused by the attempt 
on the part of any members of the family to exercise 
necessary restraint over the movements of the patient, 
are desirable. Arrangements can often be made with 
some relatives living at a distance to temporarily take 
charge of the invalid. A visit of this kind, for a few 
weeks or months, is often of the most decided service, 
and may result in entire recovery. 

It is upon this principle that the governments of 
Scotland and Belgium have provided for the mainte- 
nance of insane patients in private dwellings. This 
method of management is known as the "cottage 
system," and has produced the best of results. Prof. 
Charles A. Lee, in a recent report to the American 
Medical Association, recommends that the State, in- 
stead of supporting poor insane patients in public 
asylums, should make a weekly allowance to families 
so situated as to be able to take care of them. 



CARE OE THE FEEBLE-MINDED AND IDIOTIC. 

Unfortunately there are many families in our land 
saddened by the baleful shadow of mental imbecility 



600 CARE OF THE INFIRM. 

in one or more of their youthful members. Statistics 
inform us that there is one imbecile in every thirty 
thousand children. Some of these are found in the 
mansions of the rich, some in the houses of the poor, 
and some in the abodes of vice and intemperance. 

The care of the feeble-minded resolves itself into 
one of education — persistent, skilful education of the 
senses and of the mind. The most wonderful results 
have been accomplished through well-directed efforts 
in this direction. Much attention has been paid to 
this subject in the United States during the last 
quarter of a century. A little more than twenty 
years ago there was no educational establishment for 
idiots in the United States. To-day there are two in 
'New York, two in Massachusetts, one in Connecticut, 
one in Pennsylvania, one in Ohio, one in Kentucky, 
one in Illinois, and perhaps one or two others. Over 
a thousand children are under instruction in these nine 
establishments. 

Dr. Edward Seguin tells us that " twenty-one years 
ago Dr. Harvey B. Wilbur, then a physician at Barre, 
Massachusetts, undertook the novel and perilous en- 
terprise of attaching his own fortunes and those of 
his young family to the task of educating idiotic 
children. He had no predecessor in this undertaking 
in this country, and he was sustained in his good 
work, against the forebodings and ridicule of friends 
and neighbors, only by the bravery of his wife. After 
a few years, during which the young couple gave^ 
uninterrupted attention to their pupils, even to the 
extent of keeping the most helpless in their own 



THE EDUCATION OF THE FEEBLE-MINDED. 601 

bedroom, Dr. "Wilbur was called, first to Albany, and 
subsequently to organize the State institution for 
this helpless class. In planning this institution, he 
had no model for reference, nothing but books and 
theories. It was the first asylum ever expressly built 
for idiots. His practical knowledge of their wants 
during the previous two or three years, and his 
remarkable mechanical skill and peculiar sense of the 
fitness of things, enabled him to overcome, in an 
extraordinary degree, the architectural difficulties. 
Idiotic children require more room, more air, more 
light, more warmth than other children; all these, and 
especially the greater amount of room, which is indis- 
pensable in any attempt at improving these weak and 
sluggish natures, he provided for them." 

Children are allowed to remain in this training 
school so long as there is any improvement going on 
in their condition. They are kept daily in a condition 
of mental and physical activity, judiciously regulated 
by attendants, gymnasts, and teachers. The muscles, 
the senses, and the mental powers are all actively 
exercised and carefully trained. We have not space 
here for a full description of the very interesting 
methods employed for the education of these unfortu- 
nates. We merely wish to call the attention of those 
whom it may concern to the existence and general 
excellence of these important institutions. No parent, 
however wealthy, can afford at his home the same 
advantages for his imbecile child that one of these 
educational establishments offers. ]STo parent, how- 
ever poor, should neglect to make the effort to get 



602 CARE OF THE INFIRM. 

his feeble-minded child admission into such a school. 
There is a State appropriation for the benefit of those 
unable to defray the necessary expense. 

THE CARE OF THE INEBRIATE. 

It is difficult at home to do much for the reforma- 
tion of the inebriate, as many sad wives, weary with 
well-doing, will testify. Here again organized effort 
comes to the aid of the family, and provides the 
guards of an institution. There are in this country, 
as most of our readers are aware, a number of estab- 
lishments known as "Inebriate Asylums," in which 
voluntarily patients can subject themselves to those 
restraints and those means of treatment which ex- 
perience has shown to be of most value in overcoming 
the desire for strong drink. These institutions are 
peculiar, we believe, to our own country. In Europe 
they are spoken of as "the American Inebriate Asy- 
lums," and are exciting much attention and comment. 
There is no law, to our knowledge, which will permit 
of the forcible detention of a drunkard in one of these 
asylums. In many cases they can be induced to 
submit themselves voluntarily to treatment there. 
The results of this treatment are said to be, in very 
many instances, most satisfactory. "Wherever pos- 
sible, this means of reformation should not be neg- 
lected. Drunkenness is very frequently a disease, for 
which the patient ought to be cared for in an appro- 
priate hospital. 



PART III. 

DISEASES AND THEIR CURE. 




CHAPTER I. 

THE FORM AND FUNCTIONS OF THE HUMAN BODY. 

CONTENTS. 

The external form of man — The bones — The flesh or muscles — The organs 
or viscera — The contents of the abdomen — The contents of the chest — The 
contents of the skull — The special senses — External location of parts — The 
proportions of the human figure. 

AMILIAR as we are with our fellow-men, how 
few of us have ever thought upon the wonder- 
ful mechanism each of us displays, and the perfection 
of skill visible in our own construction! Such con- 
templation, however, alluring as it is, is not our pre- 
sent theme, but rather a brief and general description 
of the human body, which will acquaint our readers 
with its main features, the location of the principal 
organs, and the work each of those organs has to do 
in the promotion of life and health, so that it may 
more readily be understood what diseases arise when 
they are disturbed and disordered. A strictly practical 

( 603 ) 



604 FORM AND FUNCTIONS OF THE HUMAN BODY. 

aim, therefore, is before us, and we shall, as usual, 
attempt to explain in the simplest terms the leading 
facts of anatomy and physiology. 



THE EXTERNAL FORM OF MAN. 

In distinction from all lower animals, man stands 
erect ; his brain is above his face, not, as in brutes, 
behind it ; and his outlines present a symmetry and 
harmony which correspond with the true laws of 
beauty as developed by mathematics. 

It is noticeable that the human system is divided 
into threefold divisions ; and though perhaps of little 
scientific value, these divisions are convenient ones to 
remember in studying it. 

There are three tissues: the bones, the flesh or 
muscles, the organs or viscera. 

Three cavities : of the skull, of the chest, of the 
abdomen. 

Three functions: reception of nourishment, its use, 
and the rejection of worn-out articles. 

"We shall briefly consider each of these. 



THE BONES. 

The bones are for the purpose of sustaining and 
protecting the soft parts of the frame. They are hard, 
white, and durable, composed largely of lime and 
earthy matter, and vary greatly in form. The skull is 
globular and hollow, inclosing a cavity which contains 
the brain. The upper jaw is fastened immovably to it, 



THE BOXES. 605 

while the lower jaw is attached by a joint which 
allows free motion. 

At such a joint as this, and at all where there is 
motion, the ends of the adjacent bones are fastened 
together by tough, strong bands of tissue, called liga- 
ments. "When through violence these are torn and 
the bone slips out of its natural position, it is said to 
be "out of joint," or dislocated. 

The backbone, or spinal column, is a chain of small, 
irregular, rounded bones which extends from the skull 
down the whole length of the back. The amount of 
motion between any two of these small bones is small, 
but the flexibility of the whole column is considerable. 

The ribs spring from either side of the backbone at 
its upper half, and meet at the breastbone in front, 
inclosing the cavity of the chest, which contains the 
heart and lungs. 

At the lower part of the trunk two wide flat bones 
extend around from the backbone to the front of the 
body, inclosing a cavity in which the bladder and 
other organs are contained. These bones are the 
points upon which the thigh-bones rest and have to 
support the weight of the body when erect. 

The long round bones of the arms and legs are 
hollow, and contain the substance familiarly known 
as marrow. From their length and their greater expo- 
sure to accidents, they are more frequently fractured 
or broken than those of the trunk or head. From the 
hip to the knee, and from the shoulder to the elbow, 
there is but one bone ; while from the knee to the foot, 
and from the elbow to the wrist, there are two. 



606 FOEM AND FUNCTIONS OF THE HUMAN BODY. 

The hands and feet are provided with a large 
number of small bones. 

Taken together, the bones are called the skeleton. 
Too often its study is looked upon with horror, as 
associated with ideas of death and the grave; but 
such sentiments are unworthy the cultivated and 
Christian mind. For the thought of death should not 
be shunned, and we all know that 

"Every face, however full, 
Padded round with flesh and fat, 
Is but moulded on a skull." 

THE FLESH OE MUSCLES. 

The red flesh of animals, such as we see it on the 
butcher's block, is composed of muscles. If we ex- 
amine one, we find it is made up of a central body of 
numerous fibres, and terminates at each end, near 
where it is attached to the bone, in a dense hard band, 
which is the sinew or tendon. The central fibres have 
the power of contracting under the influence of the 
will, and this it is which gives the power of motion to 
the body. In all, there are some four hundred muscles 
in the human body, and thus a very great diversity of 
motion can be obtained. The fat is deposited between 
and around the muscles. 



THE ORGANS, OE VISCEEA. 

If we examine a human body from which all the 
parts have been taken except the bones and flesh, we 



THE ORGANS OR, VISCERA. 607 

perceive that there are three distinct receptacles or 
cavities, one in the skull, extending down the centre 
of the spinal column ; a second in the chest, surrounded 
by the ribs, and floored, as it were, by a broad thin 
muscle called the diaphragm, which is about on a level 
with the lowest portion of the breastbone; and a third, 
twice as large as the latter, extending from the dia- 
phragm to the bottom of the trunk, called the cavity 
of the abdomen. 

The purpose of these cavities is to contain the 
organs by which the processes of life are carried on, 
and the nobility of their labors, if we may so express 
ourselves, increases as we ascend from below upwards, 
from the base of the trunk to the brain. 



THE CONTENTS OF THE ABDOMEN. 

The cavity of the abdomen is principally occupied 
by the stomach and intestines, or bowels, the latter one 
long tube, twenty-five to thirty feet in length, coiled 
away below the stomach, and extending from it to the 
lower place of exit. This connected apparatus receives 
and assorts the food ; a portion it changes by the 
process of digestion into a whitish fluid which is ab- 
sorbed through the thin walls of the intestines by the 
bloodvessels, and carried to the heart ; the remainder, 
as unfit to support life, it rejects and passes on to the 
lower bowels, to be ejected from the body. 

In the upper part of the cavity, on the right side is 
the liver, and on the left the spleen. These organs 
receive in their loose tissues large quantities of blood, 



608 FORM AND FUNCTIONS QF THE HUMAN BODY. 

and are concerned in purifying it, and preparing it to 
yield more substantial nutriment to the body. 

In the lowest part of the cavity are the receptacles 
for the waste of the body and for the materials it rejects 
as useless, and here also are the places of exit where 
it casts these out. The organs which are concerned 
in the reproduction of the species are also located here. 



THE CONTENTS OF THE CHEST. 

The upper cavity of* the trunk contains on the 
right side, and on the upper portion of the left side, the 
lungs ; and on the lower portion of the left side the 
heart. 

The latter is a hollow muscle, its cavity divided into 
two compartments, both constantly filled with blood. 
It contracts powerfully about every second of time, 
and drives the vital fluid through the bloodvessels all 
over the body. All these vessels are connected with 
the heart. Those which carry it from the left side of 
the heart are called arteries. They divide and de- 
crease in size as they proceed further from the heart, 
until they become so small as to be invisible to the 
naked eye. Then they unite again and increase in 
size as they approach on their return to the heart, 
when they are called veins. They pour their contents 
into the right compartment of the organ. 

This constant motion is the circulation of the blood. 
The contraction of the heart is familiarly called its 
" beating ;" and the wave of blood which it drives at 
every beat through the arteries forms the pulse, which 



HOW THE BLOOD CIRCULATES. 609 

we can feel at the wrist, in the neck, on the temple, 
and wherever an artery approaches a surface. Phy- 
sicians lay so much stress on the pulse because it 
informs them how the great central organ of life is 
working. It sympathizes with every disorder of the 
system, and therefore indicates the condition of the 
health. 

The blood in the arteries has a different color from 
that in the veins ; the former is a bright florid red, the 
latter a dark muddy red. The distinction is very 
evident on seeing them side by side, and it is an 
important one to remember, for when we are required 
to stop bleeding we must act differently when an 
artery or a vein is cut. 

The change of hue takes place in this wise: "When 
the bright arterial blood passes into the minutest 
vessels, it imparts its nutritive properties to the 
muscles, and takes from them the worn out particles 
which they throw off. It passes into the veins, there- 
fore, with a turbid and darkened current, and flows 
back to the right cavity of the heart in this condition, 
useless for further purposes of support. But nature 
is altogether too provident a mistress to throw aside 
her carefully elaborated stores after a single use. She 
takes up the venous blood, extracts the dead particles, 
refines it, restores it through chemical action to its 
original purity, and sends it back to the left cavity of 
the heart, to be driven once more through the body in 
a ceaseless round. 

This process of purification takes place in the lungs. 
The venous blood passes to them from the right cavity 

39 



610 FORM AND FUNCTIONS OF THE HUMAN BODY. 

of the heart, traverses their loose substance in myriads 
of minutest vessels, is exposed to the air, and exhales 
through the breath its effete particles, returning to 
the heart, bright, and red, and wholesome. This is 
the purpose of the lungs, this is why we breathe, and 
this is why foul and vitiated air so soon and so 
certainly taints our system. 

Were we* to cease breathing for but a very few 
minutes, the impure fluid of the veins would stagnate 
in the lungs, or pass on into the circulation, unable to 
afford the nourishment which our bodies cannot subsist 
without, not even for a minute, and the whole organism 
must cease once and forever. 

The lungs receive their supply of air through the 
windpipe, which passes up to the mouth, and the 
motion of breathing, which we do without effort, 
sleeping and waking, furnishes a constant change of 
air to be applied to the blood, which is exposed to it 
in vessels of extremely thin walls. 



THE CONTENTS OF THE SKULL. 

The hollow interior of the skull is occupied by the 
brain. When the contents are extracted, the cavity is 
found to be continuous with a long channel, which 
extends down the centre of the backbone. This 
channel is filled with material of similar character to 
the brain, called the "spinal cord," and from it 
branches extend to all parts of the body, which 
branches are the nerves. 

The brain, the spinal cord, and the nerves, together 



THE FIVE WITS. 611 

form the "nervous system," and it is through these 
portions of the body that sensations are carried to the 
brain, and there taken cognizance of by the mind. 
Through these, as its instruments, the soul acts; and 
they convey the mandates of the will to the different 
muscles. They are, therefore, the most finely organ- 
ized tissues of the body. 

THE SPECIAL SENSES. 

The various methods which nature provides for 
bringing the mind into contact with the matter which 
surrounds it are the "senses." They are five in 
number, and used to be known as " the five wits," but 
among physicians are called "the special senses." 
They are the sense of sight, the sense of hearing, the 
sense of smell, the sense of taste, and the sense of 
touch. Their appropriate organs are the eye, the ear, 
the nose, the tongue, and the surface of the skin. 

In health the sensations these organs perceive are 
similar in all when excited in a similar manner. But 
in disease one or more of them become disturbed, and 
it is part of one's duty in examining the sick to ascer- 
tain which of the senses does not perform its function 
properly. Often, without obvious cause, the patient 
will complain of hearing a buzzing or ringing sound, 
or seeing images and figures where none exist, or 
having a bad taste, or being troubled with a disagree- 
able odor — all of which are delusions, arising from 
a disturbed condition of the special senses, and indi- 



612 FORM AND FUNCTIONS OF THE HUMAN BODY. 

eating the presence of a diseased state of the person's 
system. 

The attendant must be prepared to understand this 
and to know how much faith to place in such complaints, 
and what construction to give them. 

EXTERNAL LOCATION OF PARTS. 

Few of our readers would be benefited by a more 
detailed description of the internal arrangements of 
the body. But all will find it to their advantage to 
know where the principal organs are situated with 
reference to the surface of the body. 

The lungs are in the upper portion of the chest, 
from the collar-bone downward. The right lung de- 
scends somewhat lower than the left, the latter leaving 
room for the heart. The latter organ is beneath the 
left nipple. Below it, close to the lower edge of the 
ribs, is the spleen. To its right, in the middle line of 
the body, and just below the breastbone, is the stomach. 
On the right side, beneath the lower edge of the ribs, 
is the liver. 

The abdomen is filled chiefly with the bowels. At 
its lowest part, and directly in the middle line, is the 
bladder. The kidneys are somewhat high up in the 
back, just below the level of the liver, one on each side 
of the backbone. 




To/acep. 613 'i HE EXTERNAL LtOUATluA OF THE ORGANS. 



MEASUREMENTS OF THE BODY. 613 



PROPORTIONS OF THE HUMAN FIGURE. 

The size and lengths of the different parts of the 
human body are not arbitrary nor irregular, as might 
be supposed from a careless examination. They are, 
on the contrary, rigidly conformed to laws. 

Take a well-proportioned man, and you will find his 
total height is equal to the distance between the tips 
of his fingers when the arms are extended. Measure 
him through the chest from one armpit to the other, 
and five times this will equal his height. His head is 
one-eighth of his whole height ; while his body and 
head together equal in length his legs. 

These and many other minor measurements are well 
known to sculptors, modellers, and painters. They 
are found to hold good in the finest ancient statues. 
And the form is the more perfect, the more closely it 
approximates them. 

HEIGHT OF THE BODY. 

The body continues to grow to the age of twenty- 
five and sometimes thirty years. It remains station- 
ary in height for about thirty years more. Then it 
decreases slightly, owing to flattening of the carti- 
lages between the bones of the spinal column. 

The average height of full-grown men differs in 
different nations. In Belgium it is sixty-six inches ; 
in England, sixty-six and a half inches ; in some parts 
of Germany, sixty-eight inches; in this country, sixty- 
eight inches, or very near that. 



614 FORM AND FUNCTIONS OF THE HUMAN BODY. 

Full-grown women are in all these countries, on an 
average, four inches shorter than men. 

WEIGHT OF THE BODY. 

The average weight of grown men differs also in 
different countries. As a rule, it is in proportion to 
the height. For every one inch in height over five 
feet, we may expect an increase of five pounds in 
weight. 

An excellent statement to remember in regard to 
the relation of weight to height is the following*: As 
a rule, it may be laid down that an adult male, in 
good health, 66 inches in stature, ought to weigh 
rather more than 140 pounds avoirdupois. And for 
every inch above and below this height, we may re- 
spectively add and subtract about five pounds. 

Individuals may be found who vary very greatly 
from the above stated proportions; but, as a rule, 
twenty per cent., or one-fifth, is almost the greatest 
variation within the limits of health. 

The following table, showing the height, weight, and 
medium measure around the chest on the level of the 
nipples, will be of general interest: — 



KELATIONS OF HEIGHT TO WEIGHT. 



615 



HEIGHT. 




WEIGHT. 




MEDIUM CHEST 


5 feet 1 inch, 


should weigh 120 lbs. 


34.06 inches. 


5 " 2 inches, 


it 


u 


125 


it 


35.13 


ii 


5 " 3 


tt 


tt 


<i 


130 


ii 


35.70 


it 


5 " 4 


tt 


tt 


u 


135 


ii 


36.26 


it 


5 " 5 


(( 


ft 


l( 


140 


ii 


38.83 


ii 


5 " 6 


tt 


tt 


t( 


143 


ii 


37.50 


ii 


5 " 7 


(4 


it 


ii 


145 


ii 


38.16 


it 


5 " 8 


tt 


ii 


ii 


148 


ii 


38.53 


tt 


5 " 9 


tt 


tt 


ii 


155 


ii 


39.10 


tt 


5 "10 


(I 


it 


ii 


160 


ii 


39.66 


tt 


5 "11 


l( 


K 


ii 


165 


ii 


40.23 


tt 


6 " 




ii 


ii 


170 


it 


40.80 


tt 



English writers, in making calculations about the 
working capacity of a man, take as his weight 150 
pounds. This is their "one man power." It is 
somewhat too high. About 144 pounds avoirdupois 
would be more correct. This, to a height of 5 feet 
6J inches, represents the average Englishman. The 
races are so mixed in this country that it is difficult 
to say how far the pure Anglo-American varies from 
this, but the difference is little. Probably, for his 
height, he weighs a little less. The dryness of the 
air is not favorable to corpulence in our country. 
"Women average about twenty pounds less than men. 



RELATIONS OF HEIGHT AND WEIGHT TO HEALTH. 



Tall men are not usually strong men. Their bones 
are not so strong, nor are their muscles so round and 
firm, as those of medium height, or the decidedly 
short. 

Vital forces are stronger in short than in tall men. 



616 FORM AND FUNCTIONS OP THE HUMAN BODY. 

The circulation of the blood is easier, and diseases of 
the heart and lungs less common. The vital force is 
also sooner exhausted in tall men. They have less 
endurance than short ones. Hunger, fatigue, and 
sickness break them down sooner. Their prospect of 
life is more unfavorable. 

Most tall persons have narrow chests. Broad- 
chested people are usually short. Very long-lived 
and powerful people generally have short legs, long 
bodies, and short necks. President John Quincy 
Adams was such a figure, and he lived beyond eighty, 
and was very muscular. He could stand between two 
barrels of molasses, and, placing his fingers of one 
hand under the rim of each, lift both into an upright 
position at once. 

Baron Alexander von Humboldt was also such a 
figure. He lived to be ninety-two, and made some of 
the most difficult and perilous mountain ascents on 
record. 

THE EXPECTATION OF LIFE. 

We have mentioned (see p. 42) the normal duration 
of human life, the length of time man ought and may 
live. Statisticians have found out pretty closely the 
actual average duration of life; not only so, but the 
average duration of life from each year of a man's 
age. The time which men, on the average, live after 
they have reached any given age, is called "the expec- 
tation of life," at that age. It is upon this "expecta- 
tion" that life insurance companies figure. We give 



EXPECTATION OP LIFE. 



617 



below the table of average duration of life commonly 
used by them, known as the " Carlisle Table" : — 



AGE. 


EXPECTA- 
TION. 


AGE. 


EXPECTA- 
TION. 


AGE. 


EXPECTA- 
TION. 


AGE. 


EXPECTA- 
TION. 





38.72 


18 


42.87 


35 


31.00 


52 


. 19.68 


1 


44.68 


19 


42.17 


36 


30.32 


53 


18.97 


2 


47.55 


20 


41.46 


37 


29.64 


54 


18.28 


3 


49.82 


21 


40.75 


38 


28.96 


55 


17.58 


4 


50.76 


22 


40.04 


39 


28.28 


56 


16.89 


5 


51.25 


23 


39.31 


40 


27.61 


57 


16.21 


6 


51.17 


24 


38.59 


41 


26.97 


58 


15.55 


7 


■50.80 


25 


37.86 


42 


26.34 


59 


14.92 


8 


50.24 


26 


37.14 


43 


25.71 


60 


14.34 


9 


49.57 


27 


36.41 


44 


25.09 


61 


13.82 


10 


48.82 


28 


35.69 


45 


24.46 


62 


13.31 


11 


48.04 


29 


35.00 


46 


23.82 


63 


12.81 


12 


47.27 


30 


34.34 


47 


23.17 


64 


12.30 


13 


46.51 


31 


33.68 


48 


22.50 


65 


11.79 


14 


45.75 


32 


33.03 


49 


21.81 


66 


11.27 


15 


45.00 


33 


32.36 


50 


21.11 


67 


10.75 


16 


44.27 


34 


31.68 


51 


20.39 


68 


10.23 


17 


43.57 















Other tables vary this expectation from one to two per cent. 




CHAPTER II. 

DISEASES, AND HOW TO DISTINGUISH THEM. 

CONTENTS. 

Incurable diseases — Diseases that cannot be recognized — How to distinguish 
diseases — How to examine an invalid — The pulse — The tongue — The mind 
and special senses — The organs of breathing — The heart — Organs of diges- 
tion — The appetite — Vomiting — Thirst — Action of the bowels — The kid- 
neys and bladder — The skin — Behavior in the sick-room — The distribution 
of disease ; In New England; The Atlantic States; The Central States; 
The Pacific States. 



EW persons have any idea of the vast number 
of maladies which may attack our bodies, and 
either destroy them, or incapacitate us for a longer or 
shorter time. Recently, the College of Physicians 
of London published a list of all the diseases known 
— a Nomenclature of Diseases, as it is called — and the 
formidable catalogue alone covers 327 pages of larger 
size than this ! The number, to estimate them roughly, 
certainly extends beyond 1200. 

What a labor must it be to study and recognize each 
of these, and to be ready with the appropriate remedy 
in every case ! "We venture to say that even the most 
learned physician is not equal to such an undertaking. 
How vain would be the attempt, therefore, to give 
sufficient information in a work like this, and to those 
(618) 



THE DISEASES MENTIONED IN THIS BOOK. 619 

unacquainted with the many allied sciences, to enable 
them to treat every malady successfully! 

Fortunately, this necessity is not thrust upon us. 
"We can at once leave out of account all those com- 
plaints which are never or very rarely seen in this 
country; we can omit all those which are extremely 
difficult of recognition; and we can confine ourselves 
to those which are met with frequently, and which, 
though only a score or so in number, embrace nine- 
tenths of the cases of sickness that one is called upon 
to take charge of. 

INCURABLE DISEASES. 

Some, but happily very few, diseases are almost 
incurable. The best we can do is to alleviate the 
sufferings of the invalid, to protract life a few 
weeks or months, and to soothe the passage to the 
grave. To cure them is as yet beyond the reach of 
art. They occasionally get well, but rather by a 
spontaneous effort of nature, seconded by favorable 
surroundings, than by any medicines we can give 
them. 

Cancer, consumption, insanity, and hydrophobia 
are examples. A small percentage of all of these 
recover apparently without any special treatment; so 
that there is hope in every case. "What can be done 
for them is mainly through good nursing, concerning 
which we have spoken at length in the previous part 
of our work. I*i the present portion we intend to 
speak only of such diseases as can he cured, and in the 



620 DISEASES AND HOW TO DISTINGUISH THEM. 

treatment of which, therefore, we feel that we have 
strong and effective weapons to combat the foes we 
meet. 

DISEASES THAT CANNOT BE EECOONIZED. 

We may cut off of our list another class of diseases, 
that is, those which cannot be recognized and distin- 
guished by persons who are unacquainted with physi- 
ology, anatomy, and the various methods of detection 
used by trained physicians. It is out of the question 
to presume that any large number of our readers have 
made these studies, and it were useless, therefore, to 
waste their time by detailing symptoms which they 
could not detect. Modern medicine has called to its 
aid, in this field, some of the most ingenious devices 
of mechanical science, and has perfected instruments 
of such delicacy, and so difficult to use, that months 
and years of training are essential to educate the hand 
and the eye and the ear to employ them successfully. 

Such instruments are of the utmost value to the 
skilled physician, but in the hands of any other person 
are useless lumber, and it would be entirely out of 
place to describe them here. 

Our purpose is to speak only of such diseases as 
are comparatively frequent in the United States, such 
as can be treated with a fair hope of success, and such 
as, with due regard to our descriptions, can be readily 
distinguished by readers who are not physicians, and 
have no acquaintance with the sciences of anatomy, 
physiology, and chemistry. By so doing, we believe 
we can place in the hands of those who, for any cause, 



HOW TO EECOGXIZE A DISEASE. 621 

are thrown upon their own resources, the means of 
preserving the health and lives of their neighbors and 
themselves. 

HOW TO DISTINGUISH DISEASES. 

Every person who would undertake the cure of dis- 
eases must first qualify himself to recognize, after a 
short examination of an invalid, what the complaint is 
that in any given instance requires his care. To do 
this successfully in all cases is by far the most difficult 
portion of the physician's art, and even the most care- 
ful and the most skilful do now and then fall into 
errors of a grave kind. But in the majority of dis- 
eases, especially those which prevail most largely in 
this country, there is no special difficulty. 

Indeed, we are prepared to maintain that any intelli- 
gent person with ordinary powers of observation, even 
though he or she has no knowledge of the niceties of 
anatomy and physiology, can, after a little practice, 
recognize very certainly what a common disease is. 
What is needed is to know precisely the points which 
demand attention, and which serve to distinguish 
one malady from another. These are neither very 
numerous nor very difficult to remember. "We shall 
detail them with brevity and with perspicuity. 

One can learn very much of a disease without 
asking the invalid a question, simply by looking at 
him carefully. It is to be borne in mind that certain 
ages are more liable than others to certain complaints. 
Consider, therefore, the age of the patient, and also the 
sex. Lay your hand on the face and feel if it is colder 



622 diseases and how to distinguish them. 

or warmer than natural. Observe whether the cheeks 
and lips are flushed and burning as in fever, or pale 
and cold as in a chill. Vomiting, coughing, and the 
mental condition are visible at once. The position in 
which a sick person sits or lies is often indicative of 
an attempt to avoid pain. These and similar hints, 
which will readily suggest themselves, will often go 
far to show the character of the complaint before the 
invalid is asked a question. They must all be borne 
in mind. But there is great danger of a too hasty 
conclusion, so that before a decided opinion is formed 
a regular examination should be instituted. "We will 
explain how to do this. 



HOW TO EXAMINE AN INVALID. 

Diseases are divided into groups, not many in 
number, depending upon the part of the body which 
they attack. Hereafter we shall go more minutely 
into the characters of each disease. Now we shall 
only indicate how the examination is to progress, in 
order to decide as to which group any given disease 
belongs. 

When seeing a patient for the first time, if he is 
able to speak, do not commence your inquiries by the 
foolish question, "What is the matter with you ? which 
of course he is not likely to know, but ask, What do 
you complain of? or, Where do you feel pain? Next 
inquire how long he has been ill, and whether he has 
had such attacks before. 

The replies to these queries will probably put you 



HOW TO EXAMINE AN INVALID. 623 

upon the track at once, as to the locality and general 
nature of the disease. But they must be followed up 
with an examination of the general condition and 
symptoms of the patient. 

THE PULSE. 

The traditional plan is to commence by feeling the 
pulse, and it is well to observe this time-honored 
usage. It is usual to feel it on the artery just above 
the wrist, on the same side as the thumb. A very 
little practice will enable any one to find it without 
difficulty. It should be felt by pressing gently upon 
it with the tips of the fore and middle fingers of the 
hand. Its beats are thus rendered very distinct. In 
health the pulse beats about 70 or 75 times a minute. 
If much slower or much faster than this, it may be 
taken for granted that the cause is disease. In fevers 
it increases to 100, 120, and even 150 beats in a 
minute. "When much slower than natural, some 
disease of the heart or the brain is apt to be present. 
"When it is much more distinct than usual, and feels 
hard and bounding under the finger, it indicates 
violent fever. When several times during a minute a 
beat is lost, it is to be attributed either to disease of 
the heart or serious general prostration. 

THE TONGUE. 

The next step which is customarily taken is to look 
at the tongue. There is very much to be learned by 



624 DISEASES AND HOW TO DISTINGUISH THEM. 

this, but we think it needless to give more than 
general hints here. The reason why we attach so 
much importance to the appearance of this member 
is, that it indicates very closely the condition of the 
stomach and bowels, and in general of the lining 
membranes of the interior passages of the body. In 
slight fevers and moderate disturbances of the system, 
it will be observed to be covered with a light whitish 
or yellowish furry coating. In more severe fevers the 
fur becomes brown, dry, and cracked. "When the 
tongue is large, " flabby," and moist, and especially if 
it is pale, it betokens a debilitated system, and a lack 
of rich blood. If it is bright red, looking almost like 
raw meat, it indicates an inflammatory condition of 
the stomach. It is important for every one who 
would form any opinion of the appearance of the 
tongue in sickness^ to become familiar with it as it is 
in health, and, therefore, he should examine his own 
and others' as opportunity offers. 

"When this general inspection is over, it is time to 
proceed to ascertain the condition of the various 
portions of the body. The simplest plan to adopt is 
to commence at the head and go down. 



THE MIND AND SPECIAL SENSES. 

The head, every one knows, contains the brain, 
which is the seat of our senses, intellectual faculties, 
and nervous powers. Each of these should now be 
investigated. 

The mind, or intellectual faculties, are usually 



HOW TO EXAMINE THE LUNGS. 625 

obscured and dull at the outset of any violent disease. 
The patient answers questions with effort, and often 
incorrectly. Later, this may pass into delirium, marked 
by incoherent talk and false imaginings. The spirits 
are generally depressed in all diseases, but especially 
in those of the stomach, liver 7 and heart. Extreme 
nervousness is a frequent and painful associate of 
sickness. The irritability of temper which accom- 
panies it must be looked upon as a pure symptom of 
the illness. The amount of sleep taken should be 
carefully ascertained. In the onset of many acute 
diseases, the invalid sleeps much more than usual ; 
while later, and in chronic complaints, that is, those 
of long standing, more frequently sleeplessness is a 
prominent and unpleasant symptom. 

The special senses are five, viz., sight, hearing, taste, 
smell, and feeling. In diseases of the brain, and in- 
flammation of the organ, the eye cannot bear a bright 
light. Dimness of sight often accompanies general 
exhaustion. When a sick person does not blink 
before a bright light suddenly brought before the 
face, it is ominous of a dangerous condition of the 
brain. 

The hearing at the commencement of fevers is often 
dull. There is a ringing sound in the ears, and a 
throbbing sensation. In diseases marked by much 
nervousness there is great sensitiveness to noise, so 
that even the slightest is almost unbearable. In pro- 
portion as this diminishes, we may regard our patient 
as improving. 

The taste is nearly always amiss in illness. "When 

40 



626 DISEASES AND HOW TO DISTINGUISH THEM. 

persons are "bilious/' they will generally be found to 
complain of a bitter, coppery, or metallic taste. At 
other times the sense is almost or wholly lost. 

The power of smelling is also much diminished in 
sickness, and some fancied disagreeable odor is often 
mentioned. 

Having thus possessed ourselves of the condition 
of the sick person in mind and senses, we next should 
direct our attention to 



THE ORGANS OE BREATHING. 

The odor of the breath should be noted first. "When 
very foul, it certainly indicates disease. "When the 
odor is a sickly sweetish, we may conclude the lungs 
are out of order ; when putrid on approaching it, the 
cause may be decayed teeth or dyspepsia, or the decay 
of the blood which takes place in any wasting disease. 

Next to the odor, the frequency of the breathing 
should be marked. In health and repose, we breathe 
seventeen or eighteen times a minute ; in a fever the 
respiration runs up to twenty or twenty-five times ; 
and in inflammation of the lungs often to thirty, forty, 
and even faster in the same space of time. It is best 
to count the respirations without letting the invalid 
be aware of it, as very many exercise some constraint, 
although involuntarily, upon their breathing, if in- 
formed that it is being counted. 

The voice should be noted carefully. When unu- 
sually feeble, it indicates prostration ; when hoarse or 
croupy, inflammation about the organs of speech. It 



HOW TO EXAMINE THE LUNGS. 627 

is totally lost sometimes in the early stages of con- 
sumption, and in some other and less serious diseases. 

Soreness or pain, increased on taking a long breath, 
points very strongly to some local affection in this part 
of the body. 

But the commonest of all symptoms of diseases of 
these organs is a cough, and it demands therefore 
careful inquiry. Its frequency should be ascertained, 
its violence, whether it is accompanied by expectora- 
tion or is dry, and what seems most quickly to excite 
it. A "winter cough," as it is called, is a pretty 
certain symptom of chronic bronchitis. A slight 
"hacking" cough of long standing often precedes 
consumption. Sometimes a very violent cough is 
produced by a tickling sensation in the throat. But 
it must be remembered that a cough may sometimes 
be obstinate and severe, yet not indicate any disease 
of the lungs, as it may arise from pressure caused by 
the liver or stomach, or from irritation at the upper 
part of the windpipe. 

The expectoration, or what is coughed up, comes 
next in order. This is generally mucus which has 
been secreted by the lining membranes of the air-tubes 
in the lungs. Its color and consistency are highly 
instructive. In ordinary colds it is whitish or yel- 
lowish, and moderately tenacious ; in inflammation of 
the lungs it is the color of iron-rust, and exceedingly 
" sticky," clinging to the sides of a vessel almost like 
glue ; whenever these latter characteristics are per- 
ceived, it indicates mischief. The presence of blood 
is of serious moment. "When it comes from the lungs, 



628 DISEASES AND HOW TO DISTINGUISH THEM. 

it usually is bright red in color, and rises to the mouth 
almost pure. If only in streaks mixed with mucus, 
it may be from the throat. "When dark-colored and 
partly clotted, it is probably from the nose, teeth, or 
stomach. The amount must be inquired, as well as 
whether it has any peculiar taste to the patient. Fre- 
quently a salt taste is spoken of, which indicates an 
excessive secretion of this substance from the blood, 
and is often associated with spitting of blood. 

Having satisfied ourselves by these inquiries regard- 
ing the organs of respiration, we next pass to those 
located immediately adjacent to them, the organs of 
circulation, especially 

THE HEART. 

This is situated in the left half of the chest, nearly 
beneath the left nipple. If the hand is laid upon this 
portion of the body, the beats can be distinctly per- 
ceived and counted. They should be moderate in 
force and regular in sequence. Some persons suffer 
much from a sense of fluttering or palpitation at the 
heart, even to the extent of causing faintness. Others, 
without actual pain, complain of a sense of "goneness," 
which leaves them exhausted and almost breathless. 
Pain over the heart, though always requiring careful 
investigation, may arise from many quite insignificant 
causes, and should not excite needless alarm. 

Most of the diseases to which this important organ 
and the large arteries near it are subject, can only be 
distinguished by a practised physician and the em- 



HOW TO EXAMINE THE GUMS AND TEETH. 629 

ployment of complicated apparatus, so that we shall 
not enter into their description in this volume. Suffice 
it to say that the danger and fatality from disease of 
the heart are much exaggerated by the popular mind. 



ORGANS OF DIGESTION. 

To examine these properly, we must commence at 
the mouth, for there in one sense the process of diges- 
tion begins. 

The teeth are a very important aid in this process, 
and it is surprising how many cases of dyspepsia and 
general ill -health arise from a neglect of using them 
and keeping them in good order. Often all medicines 
are useless until some foul and decayed teeth are 
removed, some old roots extracted, or a set of artificial 
teeth obtained. 

The gums deserve close inspection. Sometimes a 
single glance at them reveals the hidden origin of a 
multitude of wretched sensations. In scurvy and 
some similar complaints they are red, spongy, swollen, 
and bleed almost on the slightest pressure. When 
the system is poisoned by lead, as may occur from 
working with lead paint, or from drinking water 
which has been conveyed in lead pipes, or from using 
hair color restorers or cosmetics containing this 
mineral, there is a faint blue line on the edge of the 
gums. In exhausting fevers, and when the invalid is 
much worn down, a brownish or whitish matter 
collects around the edges of the gums and teeth. 
Any of these appearances must be carefully noted. 



630 DISEASES AND HOW TO DISTINGUISH THEM. 

The saliva, or spittle, is occasionally of much 
significance. "When a person has taken mercury and 
some other drugs in excess, they cause an unusual 
flow of this fluid, which phenomenon is called " sali- 
vation." The taste and color are also sometimes 
altered. 

Passing downward, we next examine the throat. 
To do this, have the invalid open his mouth, and 
taking a spoon, press the tongue gently, but firmly, 
down with the handle. A very little practice will 
enable any one, by this means, to obtain a very good 
view of the upper portion of the throat. It is best to 
obtain a good light by seating the patient in a chair 
facing a window, and, having his head thrown back, 
allow, by standing a little to one side, the light to fall 
upon the back part of the throat. "We can then 
distinctly see the uvula and the tonsils. The uvula is 
a small, fleshy body, that hangs from the middle of 
the back portion of the roof of the mouth. Sometimes 
it is enlarged and lengthened, causing difficulty in 
swallowing, and a distressing cough, from tickling 
the throat. Below and beyond it, on either side of 
the throat, can be seen two bodies about the size and 
shape of almonds. These are the tonsils. They are 
often swollen, and sometimes ulcerate and give rise to 
much pain. They can be treated either by gargles, or 
by direct application of substances carried through 
the mouth on a camel's-hair brush with a long handle. 

In some persons such an examination of the throat 
as we have described causes retching and even 



INQUIRIES IN REGARD TO THE APPETITE. 631 

vomiting, but this need not give alarm, as these 
unpleasant symptoms promptly pass away. 

In this connection it should be ascertained whether 
there is any difficulty or pain in swallowing, and at 
what part of the throat this seems to be. 



THE APPETITE. 

Disorder of the health probably shows itself nowhere 
more promptly than in our desire for food and drink. 
Usually at the onset of all diseases the appetite is 
decreased or altogether lost. Sometimes an actual 
aversion for food occurs. At others, the desire is 
fitful and capricious. Children with worms, and 
young girls who have "green sickness," will at one 
meal eat large quantities, and at another almost 
nothing at all. Nearly all such patients crave some 
single or unusual article. One will want pickles, 
another sweets ; some have a longing for chalk, others 
for slate-pencils. Such unnatural tastes should not 
be punished as wilful bad habits, but be regarded as 
evidence of a disease which requires judicious manage- 
ment and kind treatment. 

A voracious appetite is common in tapeworm, in 
the convalescence from acute diseases, and in some 
cases of dyspepsia. Often it is supposed to be a 
favorable sign when in reality it is quite the reverse. 

In health, "good digestion will follow on good 
appetite," but in most diseases more or less discomfort 
is felt in the stomach or bowels immediately or soon 
after eating. The character, locality, and frequency 



632 DISEASES AND HOW TO DISTINGUISH THEM. 

of this should be ascertained. Often it is only a 
sense of weight or pressure, due to a lack of power in 
the stomach to digest the food which has been thrust 
into it. Sometimes it is nausea, which is a desire to 
vomit without actually leading to vomiting. 

VOMITING. 

When vomiting does occur, it should be carefully 
noted. Its cause should be asked, its frequency, and 
whether it is accompanied by much effort and any 
pain. The material vomited is instructive. When it 
consists merely of the food and drink which have been 
taken, we may justly suppose that the stomach has 
merely been overladen. Sometimes a greenish fluid, 
with a bitter taste and smell, is thrown up. This is 
"bile," and a person in this condition is popularly 
called "bilious." Once seen, this substance can 
always be recognized. It indicates torpidity of the 
liver and stomach. More serious is it when there is 
appearance of blood in the vomited matter. It is 
necessary to be sure that this did not come from the 
nose, from the teeth, or from some wound in the 
mouth. When from the stomach, it is very dark- 
colored, clotted, and mingled with food. Several 
causes may give rise to it, an ulcer on the stomach, 
a cancer, or the inflammation of the lining membrane 
of the organ which often follows long-continued and 
excessive use of alcoholic beverages. 



HOW TO EXAMINE THE DIGESTIVE ORGANS. 633 



THIRST. 

The thirst felt by a patient is a marked symptom of 
nearly all fevers, and is not less notable in wounds. 
None but those who are familiar with the tales of 
terrible suffering which the wounded in a battle 
experience for want of water can adequately appreciate 
it. It is their first and most importunate demand. 
This is because they lose much blood, and failing in 
its vital fluid the body urgently demands some other 
to replace its waste. The cruel treatment of a bygone 
age was to deny to fever patients that which beyond 
all else they crave — cool water; but now a more 
enlightened practice recognizes in this urgent longing 
a call of nature which it is most wise to satisfy to its 
full extent. 

Occasionally a dislike or horror of liquids, even 
extending to the sight or sound of them, is manifested. 
From this striking symptom the disease brought about 
by the bite of a mad dog is called " hydrophobia," 
which literally means " a dread of water." The same 
dread or dislike is at times one of the freaks of the 
insane, and we have witnessed these unfortunates 
actually die of thirst rather than be prevailed upon to 
touch any fluid ! 

Other points relating to the digestion are the fre- 
quency of eructation or belching, the tendency to 
taste food for hours after it has been swallowed, the 
rising of water in the mouth (water-brash), and the 
sense of heat in the pit of the stomach popularly 
called "heartburn." All these are symptoms of indi- 



634: DISEASES AND HOW TO DISTINGUISH THEM. 

gestion, and there are a legion more which we need 
not rehearse here. Suffice it to say that it is in this 
connection they should be inquired into. 

ACTION OF THE BOWELS. 

The food we take enters at the mouth and passes to 
the stomach and bowels. In these organs that portion 
of it which is fitted to nourish the body is digested 
and taken up by the various machinery which nature 
has provided for the purpose, w T hile the remainder, as 
not available, is rejected, and left to pass out at the 
extremity of the bowel. It is highly important, in- 
deed indispensable to the general health, that this act 
should be performed regularly every day. Therefore 
in the examination of every sick person this inquiry 
must be put : Have your bowels moved to-day? "When 
did they move last? How often in twenty-four hours 
(if there is a tendency to diarrhoea)? Not only this, 
but the color should be ascertained. "When very light 
or clay-colored, it signifies want of action of the liver. 
If watery, there is diarrhoea ; if blood is present in the 
stools, and there is pain in the act and a frequent 
desire to repeat it, it means dysentery or "bloody 
flux." "When the stools are passed involuntarily, in 
adults, it is justly regarded as an alarming proof of 
other physical or mental prostration. The presence 
of worms in the bowels is often shown by their occa- 
sional appearance in the passages. 



HOW TO INQUIRE ABOUT THE KIDNEYS. 635 
THE KIDNEYS AND BLADDER. 

The fluids which are no longer needed in the body- 
pass off by means of the lungs, the skin, and the 
kidneys. The latter secrete the urine, which is tem- 
porarily retained in the bladder. This secretion is of 
such importance that when it is suspended for a few 
hours fatal poisoning may ensue from the impure 
matter retained in the blood. Inquiry therefore 
should always be made as to the healthy action of 
these organs. The question is usually put in this 
form: "When did you last pass water? Its frequency, 
whether it is painful or 'not, and the amount passed at 
a time are all instructive facts. The color of the 
water differs very much. In fevers usually the fluid 
is scanty and darker than in health. The odor also is 
more stale and offensive. When the amount is unusu- 
ally great, and light in color, it may signify the pres- 
ence of the disease known as diabetes, which is one of 
serious character. When the water is cloudy and 
turbid, or slightly tinged with blood, we may suspect 
some inflammation of the bladder. 

The deposits which are formed after the water has 
stood some time are extremely important in revealing 
the character of any mischief which is going on, but 
they can only be appreciated by one acquainted with 
the use of the microscope and the application of chemi- 
cal reagents, so we shall not discuss them here, further 
than to say that the sediment resembling brickdust, 
often seen attached to the bottom and sides of the 
vessel, is not of an alarming character. 



636 DISEASES AND HOW TO DISTINGUISH THEM. 

This examination informs us with sufficient exacti- 
tude about the most important functions of the body. 
We now proceed to study the external surface, that is, 



THE SKIN. 

Its color is that which meets us at first. This 
should retain the delicate white and pink shades which 
it has in health. If pale and waxy looking, it indicates 
want of good blood ; if yellow, we will justly suspect 
jaundice and disturbance of the liver; if of a light 
greenish hue, the invalid is most probably afflicted 
with the complaint known as "green-sickness" or 
chlorosis, of which in another work we have spoken at 
some length ; and, finally, if very red, there may be 
scarlet fever or erysipelas present. 

Placing our hand upon the patient in different parts 
of the skin, we judge of its temperature and moisture. 
It may be hot and dry as in high fevers, or cold and 
clammy as in fainting, chills, and collapse, and after 
severe accidents. Excessive sweating takes place in 
acute rheumatism, in the last stage of an ague chill, 
in the night-sweats which come from exhaustion, etc. 

Every eruption which is visible on the surface 
should be examined with the greatest care and in a 
good light. Very many diseases can be distinguished 
at once by these, and in no other way. Besides the 
skin-diseases properly so called, there are many others, 
such as smallpox, chicken-pox, measles, scarlet fever, 
typhoid fever, and scurvy, each of which is accom- 
panied by a particular eruption or mark on the skin 



HOW TO BEHAVE Ltf THE SICK-ROOM. 637 

which when once known cannot be mistaken, and 
removes all doubt as to the nature of the complaint. 
"When we come to treat of these various diseases we 
shall specify what these signs are. 

At the same time we may look at the muscles, feel 
their firmness, notice whether the patient is emaciated, 
see if the joints act naturally, and note any want of 
power in the limbs, and any jerkings, twitchings, or 
cramps which they show. 

This will finish the examination, which, it will be 
seen, can be made with perfect satisfaction by any 
intelligent person, even if he has no accurate know- 
ledge of anatomy or physiology, and no other appli- 
ances than his five senses afford him. In the large 
majority of cases, he will find after some experience in 
the sick-room, that he can thus distinguish accurately 
and readily most of the prevalent diseases. 

BEHAVIOR IN" THE SICK-ROOM. 

A few words should be added on the proper manners 
which every one should adopt who undertakes the 
examination of a sick person. It should ever be borne 
in mind that in illness nearly every one is irritable, 
easily exhausted, and desirous of sympathy. Always 
manifest — and strive to feel — a kindly spirit, spare all 
needless talk, never ask the same question twice, and 
do not insist on too minute inquiries. Great delicacy 
should characterize questions relating to the bodily 
functions, and a cheering, inspiriting tone should be 
used, equally far from gayety and gloom. Call atten- 



638 DISEASES AND HOW TO DISTINGUISH THEM. 

tion to the signs that are favorable, keep silence about 
those which are not. If there is cause for serious alarm, 
tell the friends and relatives of the invalid, and let 
them take the responsibility of informing him, or refus- 
ing to do so. Do not whisper to the attendants, but 
always speak aloud, though in a low tone of voice. 
Avoid all appearance of mystery, and also all manifes- 
tations of doubt and uncertainty. 

THE DISTRIBUTION OP DISEASE. 

The emigrant, the traveller, the buyer of land, in 
fact nearly every one, is interested in knowing some- 
thing about the distribution of diseases in this country, 
that is, where certain diseases prevail and may be 
anticipated, and where they rarely or never occur. 

NEW ENGLAND. 

In New England the most frequent and fatal 
diseases are those which attack the throat and lungs, 
especially catarrh, bronchitis, and consumption. The 
latter alone destroys about one-fifth of the inhabitants 
of that district. A physician near the sea-coast of 
Maine lately stated that in his practice fully one-third 
of the deaths among his female patients were from 
this cause. On the other hand, fever and ague is 
comparatively little known, even in swampy localities. 
Medical men are of opinion that the violence of the 
swamp poison disappears as we advance north ; and 
that above the latitude of 44° it disappears altogether. 




Equator 



MEDICAL CHART 

OF 

AMERICA. 



\ I f J 






To /'ace page b38. 



THE DISTRIBUTION OF DISEASE. 639 

This is the reason that in the swamps of Nova Scotia, 
and around Hudson Bay, it is entirely unknown. 

Typhoid fever prevails extensively in New England, 
especially in the winter season, owing to the poisonous 
exhalations from individuals being confined in close 
rooms, etc. 



THE ATLANTIC STATES 

The States bordering on the Atlantic south of New 
England are subject to a damp and variable climate 
(except Florida). Their inhabitants are afflicted with 
diseases of the air-passages, though not to such a de- 
gree as in New England, but intermittent fever, and 
other disorders arising from the exhalations of low 
grounds, increase in frequency as we proceed south 
from New York city. The swamps of New Jersey, 
Virginia, South Carolina, and Georgia are especially 
notorious for their unhealthy atmosphere. In the last- 
named States, few persons escape the malarial influence 
who reside near the watercourses. 

The yellow fever often prevails in summer in 
Charleston and Savannah. A temperature lower than 
about 65° Fah. neutralizes the poison of this epidemic, 
so that but rarely, and only in the hottest months, 
could it prevail in New York, Philadelphia, or Wash- 
ington. 

Consumption decreases in virulence as a warmer 
climate is approached. On the uplands of South 
Carolina, and the mild eastern shore of Florida, its 



640 DISEASES AND HOW TO DISTINGUISH THEM. 

progress is much delayed, and, for that reason, those 
localities are favorite health resorts in that complaint. 



THE CENTRAL STATES. 

The vast sloping plain of the Mississippi Valley 
displays a great variety of climate between the metal- 
liferous and pine-clad shores of Lake Superior and 
where the tepid waves of the Mexican Gulf beat the 
low shores of Louisiana. Throughout nearly this 
whole region, however, we find the subtle poison from 
the numerous swamps producing fever-and-ague and 
its many allied diseases, such as the "dengue" in 
Louisiana, the " break-bone fever" of Arkansas, the 
"dumb shakes" of the "Wabash Valley, and the peri- 
odical neuralgias so frequent further north. 

In Louisiana the yellow fever is nearly an annual 
visitor; while, in many districts of Indiana and 
Illinois, that mysterious complaint, the "Milk-sick- 
ness," gives certain neighborhoods a fatal notoriety. 

Epidemics of dysentery are also frequent in the 
middle and southern States of this section, and in the 
cholera epidemics which we have from time to time 
experienced the severest sufferers have been some of 
the cities on the Mississippi River. 

The atmosphere is, however, drier than on the 
Atlantic coast, and, hence, is better adapted for those 
with a tendency to bronchitis or consumption. They 
very frequently experience much relief from their 
symptoms by a removal from the sea-coast to the 
interior. 



THE DISTRIBUTION OF DISEASE. 641 



THE PACIFIC STATES. 

The States and territories which border upon the 
Pacific enjoy a milder temperature than localities in 
the same latitude on the Atlantic, and it was at first 
thought and said that their healthfulness was much 
greater. Further experience has not borne out this 
opinion. Consumption and fever-and-ague seem to 
prevail quite as extensively, and to be quite as severe 
in character, along the Pacific as along the Atlantic 
coast. San Francisco is not in these respects a health- 
ful spot. The lofty plateau between the Cascade, 
Sierra ]STevada, and Pocky Mountain ranges is almost 
exempt from consumptive disease, much more so than 
any other section of our country, but this exemption 
does not extend to localities on the Pacific slope. 

Smallpox rages extensively among the Indian tribes 
of the extreme western States, and goitre develops 
itself among the inhabitants of the deep valleys in the 
mountains. 




41 



IMS** 






CHAPTEE III. 

HYGIENIC MEANS OF CURE. 

CONTENTS. 

Ancient methods of cure — The natural means of cure — Mineral springs — 
Iron or chalybeate springs — Sulphur springs — Alkaline and carbonated 
waters — Salt springs — Miscellaneous springs — Advice to those using mine- 
ral waters — Change of climate — What kind of a climate to choose — The 
climates of the United States — The most healthful warm climate — General 
directions in changing climates — The Swedish movement cure — Movements 
for cold hands and feet ; for constipation ; dyspepsia — The lifting cure — 
Electricity; how to apply it; diseases benefited by it; loss of voice; spe- 
cial s enses ; palsy ; rheumatism; poisoning, etc. 

HE end and aim of all medical art, strictly so 
called, are to cure the sick. This is its starting- 
point and its goal. To prevent disease is perhaps a 
higher aim, and can to some extent be accomplished. 
But sooner or later the inexorable Fates overtake 
every son of man, and he is stretched upon a bed of 
sickness. His one sole desire is to be heeded, and for 
this alone the doctor is summoned. If at this juncture 
his art fails him, both he and it fall into disfavor. 

ANCIENT METHODS OE CURE. 




In ancient times, and in barbarous nations, when 
diseases were looked upon as the attacks of evil spirits 
( 642 ) 



THE VARIOUS MEANS OF CURE. 643 

or the spells of some malignant sorcerer, the attendant 
called in to heal sought to scare away the demon by 
beating drums, howling aloud, rattling empty vessels, 
and making similar hideous noises. There are su- 
perstitions as gross as this now publicly prevailing in 
this country, as, for instance, the usages of the so-called 
" magnetic doctors," those who cure by the "laying on 
of hands," the clairvoyant and spiritualist medicines. 
This is all unreasonable and degrading folly. 

There is a beautiful theory that beneficent Nature 
has provided somewhere in her realm the substance 
which is the specific cure for each of those ills to which 
we are heirs. This notion, however attractive, finds 
little countenance in exact science, but it is true to 
the extent that a benign Providence has everywhere 
and abundantly placed within our reach many means 
which we can successfully apply to relieve suffering, 
to restore health, and postpone the inevitable termina- 
tion of earthly life. Experiment, thought, and intelli- 
gent observation must teach us how to use these 
means wisely, and which to recommend in any given 
case. To- bring them lucidly, in some simple yet cor- 
rect arrangement, to the knowledge of our readers, we 
shall briefly review them under the headings, Natural 
Means, Mechanical Means, and Drugs. 

To commence with 

THE NATURAL MEANS OF CURE. 

The first and most important in many respects are 
mineral waters. Indeed, every year extends more and 



644 HYGIENIC MEANS OF CURE. 

more the opinion among medical men that in the future, 
when the full virtues and proper application of these 
medicinal waters are fully appreciated, they will come 
to be regarded as by far the most important of all the 
resources at our command to attack disease. 

There is an astonishing amount of ignorance in this 
country concerning their real effects and merits, which 
is shared even by physicians. We design to dwell 
particularly upon the mineral springs of the United 
States, to describe where they are, what they contain, 
and what diseases they benefit, so that those who read 
this work, when they conclude to go to some Springs 
to regain health, shall do so more intelligently and 
consequently more successfully than the vast body of 
the present visitors. Moreover, we shall give some 
hints regarding their conduct while at a watering- 
place, which, if observed, will tend materially to their 
subsequent comfort. 

Every one knows that a mineral spring is one 
whose waters contain in solution various substances 
not found in ordinary pure water. They are divided 
according to these substances into four classes. The 
first is the chalybeate or iron springs, in which iron in 
some form gives a marked taste and effect to the 
water ; secondly, there are the sulphur springs, readily 
recognized by their odor, their milky color, and their 
sulphurous taste ; the third class includes the alkaline 
springs, which contain as their chief mineral ingre- 
dients carbonate of soda, carbonate of lime, and allied 
substances ; and, finally, the salt springs, in which 
common salt forms a large portion of the solid con- 



IRON SPRINGS. 64t5 

stituents. These classes differ very much in their 
medicinal virtues and in their value in diseases. 
Those who will derive benefit and perhaps regain 
perfect health by making use of the waters of one 
class, will be certainly,, and perchance permanently, 
injured, if they ignorantly patronize another. The 
selection of the proper water is just as important as 
of the proper drug from the apothecary's shelves. 

IRON OR CHALYBEATE WATERS. 

These waters are usually cold, clear, without any 
odor, and of an inky taste, more or less masked by 
other ingredients. When of an average strength they 
contain about a grain of metallic iron to the pint of 
water. Now iron is one of the very best tonics known 
to medicine; it is an important element in the blood, 
and its consumption, therefore, in an exceedingly 
minute division, to the extent of several grains daily, 
has an excellent effect when there is a lack of good 
blood, general debility, nervous prostration from over- 
work or anxiety, in scrofulous and consumptive con- 
stitutions, in convalescence from acute diseases, and 
in tendency to bleeding from slight causes. On the 
contrary, chalybeate waters are likely to prove injuri- 
ous to corpulent persons, with florid faces and sanguine 
temperament, to those threatened with apoplexy, in 
inflammatory disorders of the stomach, bowels, or 
other internal organs, and in fevers. 

One of the strongest chalybeate springs in the 
United States is at Schooley's Mountain, New Jersey, 



646 HYGIENIC MEANS OF CURE. 

Its waters contain two grains of carbonate of iron to 
the wine pint according to the published analysis. It 
is "hard water," that is, containing carbonate of lime 
in considerable abundance, eight grains to the pint. 
It is cool, the temperature, winter and summer, re- 
maining at 50° Fahrenheit. 

Iron springs are very numerous throughout our 
country, especially in the more mountainous portions, 
and many of them enjoy considerable local renown for 
their medicinal powers. In many of them the iron 
is associated with other ingredients, which add to its 
value in certain diseases. This is the case, for instance, 
with Anderson's Spring, at Bedford, Pennsylvania. A 
quart of its waters contains one and a quarter grains 
of the carbonate of lime and not less than twentv 
grains of the sulphate of magnesia (Epsom salts), 
which act as an efficient laxative. This renders its 
waters peculiarly suitable for persons with chronic 
liver-complaint, with piles, biliousness, obstinate de- 
pression of spirits, constipation, " ague-cake" or en- 
larged spleen, and generally where with a tonic we 
would associate something to act regularly and gently 
on the bowels. 

The "magnetic wells" of St. Louis, Michigan, have 
become somewhat prominent of late. Their water 
has the. curious property of communicating polarity 
to a needle which is left for some time in it. This 
depends upon the presence in solution of a small 
quantity of the magnetic oxide of iron, the same 
which is familiar to all in the loadstone. These wells 



SULPHUR WATERS. 



647 



have no peculiar virtues beyond other chalybeate 
springs. 

At Sharon, New York, there is a chalybeate spring 
of similar properties to that already mentioned at 
Bedford, Pennsylvania; and the Sweet Springs, in 
Virginia, which contain a grain of iron to the quart, 
and have a temperature of 73°, are others of the same 
character. 

In the Rockbridge Alum Springs, and the Church 
Hill Alum Springs of Virginia, the iron is present in 
the form of the sulphate of iron or green vitriol, and 
is conjoined with alum. These are very rarely advan- 
tageous internally, being extremely difficult of diges- 
tion; but as baths, washes, and injections, they are of 
great service in profuse secretions, in piles, in old and 
obstinate ulcers, and some skin affections. 



SULPHUR SPRINGS. 

These waters are readily distinguished by their 
color, usually slightly milky, their odor approaching 
feebly that of spoiled eggs, and their very decided 
sulphurous taste. Some are cold, others warm, and 
their water is used both internally and for baths. 
Their general action is to stimulate the secretions, 
especially of the skin, and they are in many cases 
remarkably efficacious. 

The principal diseases in which they are of service 
are disorders of the liver, including biliousness and 
piles, obstinate coughs which arise from the bronchial 
membrane of the lungs and throat, hoarseness, "clergy- 



648 HYGIENIC MEANS OF CURE. 

man's sore throat," and loss of the voice, gout, and 
chronic rheumatism, slow poisoning from lead or 
arsenic, and especially in diseases of the skin. When 
these latter are supposed to arise from some secret 
infection, a course of sulphur waters will very 
certainly decide the question, and probably bring 
about a cure. 

These springs are numerous in the United States, 
and many of them are fitted up for the comfortable 
accommodation of numerous guests. In New York 
there are the Avon and Sharon Springs, at both of 
which the waters are cold, ranging about 50° Fahr. 
At Sharon, the "White Sulphur Spring is much 
stronger, both in the sulphates and the sulphuretted 
hydrogen gas, than the magnesia spring, though the 
latter contains both these substances. Both of them 
act as efficient laxatives, and thus assist the medicinal 
action of the sulphur. 

Virginia is particularly rich in sulphur springs; the 
White Sulphur is a justly celebrated and very fashion- 
able watering-place. The waters are not so strongly 
saturated either with sulphur or the sulphates as the 
Sharon Spring, and their temperature is fifteen degrees 
higher. The constituents of the Red Sulphur Spring 
are more evenly balanced than those of the White, and 
it contains very nearly double as much sulphuretted 
hydrogen. It is admirably adapted for affections of 
the throat, and the early threatening symptoms of 
consumption. 

The Salt Sulphur is another of the Virginia springs, 
which has a wide reputation. Its waters are laxative, 



ALKALINE AND SPARKLING SPRINGS. 64:9 

and contain a large number of mineral ingredients, 
among which is common salt, the taste of which is 
quite perceptible, and from which the name of the 
spring was given. The Blue Sulphur and the Warm 
Springs, the temperature of the latter being 98°, are 
also well-known sources in the same State. The 
former is so-called from a bluish tinge derived from a 
small quantity of sulphate of iron which it contains. 
It also has iodine in solution,* and it is especially 
recommended in scrofulous swellings, and enlarge- 
ments of the glands of the neck and elsewhere. 

The Indian Springs in Georgia, Bladon Springs in 
Alabama, those at Lauderdale in Mississippi, and the 
Hot Sulphur Springs of Arkansas, are other and 
efficient sulphur waters. 

Florida, which offers so many attractions to the 
health-seeker, is also peculiarly rich in mineral springs 
of various descriptions. Of its sulphur springs we 
may mention the "White Spring in Hamilton County, 
the Orange Spring in Marion County, the Sulphur 
Spring at Enterprise on the St. John River, and the 
Warm Spring in Sumter County. At all of these 
there are accommodations for invalids, and those seek- 
ing a warm winter climate in this State will do well to 
take advantage of the opportunity, and combine with 
the change of climate a judicious course of mineral 
waters. 

ALKALINE AND CARBONATED WATERS. 

These waters are so called on account of the large 
amount of carbonic acid they contain, either in the 



650 HYGIENIC MEANS OF CUKE. 

form of gas, or, more frequently, as the carbonates of 
lime, magnesia, and soda. Some of them are cold, 
others warm. Their water is clear, often sparkling, 
and usually with a decided taste. 

The peculiar value of these waters is in obstinate 
indigestion, sourness of the stomach (heartburn, water- 
brash), and dyspepsia, where there is a tendency to the 
formation of gall-stones and stone in the bladder, in 
gravel, gout, nervous disorders, and chronic catarrh. 
On the. other hand, they will be apt to be injurious 
where the blood is thin and poor, where there is any 
hectic fever, any signs of scurvy, and general debility. 
Under any circumstances, they should be used cau- 
tiously, and not for any great length of time, as in 
such case they dilute and impoverish the blood. The 
famous Seltzer Springs in Germany, those of Vichy in 
France, and the Seltzer Spring at Saratoga, are well- 
known instances of carbonated waters. 

The Lebanon Springs in New York and the Sweet 
Springs of Virginia are somewhat similar in con- 
stituents. The temperature of both these sources is 
about 72° Fahr. 

Some of the carbonated waters are acid and others 
are alkaline, but they are all employed with benefit in 
the same diseases — chiefly those of the stomach, kid- 
neys, and bladder. 

SALT SPRINGS. 

In these springs the predominant element is 
common salt, though it is generally associated with 



BRINE SPRINGS. 651 

numerous other substances. Their medicinal powers 
are exerted chiefly in all diseases of a scrofulous 
nature, in rheumatism and gout of chronic charac- 
ter, in obstinate diseases of the skin, and in diarrhoea 
of long standing. They furnish both cold and warm 
water, clear, and with a marked salty flavor. 

Brine springs are very numerous throughout the 
United States. They form the "Salt licks" and 
"Bone licks" of Kentucky and Tennessee. In New 
York and Michigan large quantities of table salt are 
obtained from them by concentration and evaporation. 
The famous Ball st on Spa and Saratoga Springs (Con- 
gress, Union, Pavilion) belong to this class. 

Salt lakes are found in Florida (near the head 
waters of the St. John River, on its right bank), in 
Utah, and in other portions of our country. Bathing 
daily in their waters for several months consecutively 
is unquestionably the most efficient means to cure 
scrofula known to medical art. 

The ocean is a vast salt lake, possessing medicinal 
properties equal to any saline spring, and the hygienic 
uses of sea-bathing deserve prominent position among 
natural means of cure. 



MISCELLANEOUS SPRINGS. 

Various springs, not properly coming under these 
classes, have from time to time been highly extolled 
for the virtues they are averred to possess in certain 
diseases. A year or two ago, a company in New York 
advertised extensively a spring which they alleged 



652 HYGIENIC MEANS OF CURE. 

contained small quantities of arsenic in solution, and 
had the power of healing cancers ! Of course, putting 
their assertions to the test of experiment very soon 
proved that the cure for that terrible disease was no 
more possessed by them than by any other of the 
thousand pretenders who claim it. 

The proprietors of the Gettysburg Spring, Penn- 
sylvania, state that its water has a considerable quan- 
tity of the substance lithia, which has enjoyed a wide 
reputation for its power over rheumatic and gouty 
diseases of long standing. Its effects on dyspepsia 
and indigestion have also been highly lauded. 

In this country, too, interested parties have striven 
frequently to give reputation to a mineral spring, 
not from its real merit, but merely to sell its waters 
or to draw visitors to it. To such an extent has this 
been pushed, and so bold and all-embracing are the 
claims of these very partial witnesses, that a wide- 
spread suspicion stands ready to meet all such 
attempts in future. It is our advice to distrust all 
circulars and analyses of hotel-keepers and proprietors, 
and to take the opinion of a competent and unpreju- 
diced physician as to what spring suits any individual 
case. 

We now proceed to give some general 

ADVICE TO THOSE USING MINERAL WATERS. 

No water whatever will cure or even benefit the 
invalid, unless he submits himself, his habits, and his 
diet rigorously to certain rules. "We can only lay 



HOW TO DRINK THE MINERAL WATER. 653 

these down for him in a general way, and leave to his 
medical adviser the task of detailing them more 
minutely. 

A regular course of mineral waters is only of service 
in chronic diseases, and then only when they have not 
gone too far. "When it is determined to undergo this 
treatment, it should preferably be done at the springs. 
To be sure, the water of most of the famous sources 
is bottled and can be had in the drug-stores, but not 
only is it generally fresher and purer at the fount 
itself, but the journey thither brings with it change 
of air and diet, relaxation, rest, and amusement. The 
warm months of the year are at once the most pleasant 
and the most judicious period to commence. Should 
it, however, be begun in the cold months, smaller 
quantities of the water should be used, and unusual 
precautions be taken about exposure. 

The amount to be taken is a matter of far more 
importance than persons generally suppose. The 
custom with many is to let appetite or passing incli- 
nation govern this. On the contrary, it should be 
strictly regulated. Commence with a small quantity 
taken at regular hours. The usual time is in the 
morning, before breakfast, letting at least half an hour 
elapse between the drink and this meal. Smaller 
doses may be taken about the middle of the morning 
and toward the close of the afternoon, and in the 
evening either only a quite limited quantity or none 
at all should be taken. 

A careful diet is absolutely essential to success. 
The breakfast should be light, the dinner abundant but 



654: 



HYGIENIC MEANS OF CURE. 



not rich, the supper scanty. The meals should be 
taken at regular hours, highly-seasoned dishes of all 
kinds avoided, coffee, tea, and tobacco either eschewed 
altogether, or indulged in with great moderation, and 
spirituous liquors wholly banished. 

Gentle and daily exercise should be sought, but 
over-exertion, late hours, and loss of sleep must be 
shunned. The frequency of dances, " hops," and ex- 
citements of various kinds at our fashionable watering- 
places, is out of place and injurious to the health-seeker, 
however agreeable to the pleasure-seeker. Above all, 
the invalid should leave all home-cares at home, dis- 
pel anxiety respecting the future and grief concerning 
the past, and cultivate serenity of temper, a hopeful 
spirit, and a determination to improve. So doing, he 
will double and treble his chances for recovery, and 
render a powerful aid to the curative means he is 
engaged in testing. 



CHANGE OF CLIMATE. 

This is among the natural means of cure not less 
important, and sometimes more so, than the ready- 
made potions we have just been discussing. The re- 
mark is made by an eminent London physician : "It 
would be difficult to point out any chronic complaint, 
or even any disordered state of health, which is not 
benefited by a timely and judicious change of climate." 
"We shall specify in what complaints an improvement 
by this means may be most confidently looked for, and 



BENEFITS OF CHANGE OF CLIMATE. 655 

shall then proceed to discuss the medicinal merits 
which the various climates of our own country possess. 

Probably in no disease are these benefits more con- 
spicuously exhibited than in that one where all other 
means notoriously and nigh uniformly fail — that is, 
consumption. All of us must have known repeated 
instances of persons who, in the opinions of their friends 
and their physicians, seemed inevitably destined for an 
early grave, and who by a long visit to some warmer 
or drier climate have restored themselves to perfect 
vigor and activity. 

A complaint sometimes mistaken for consumption 
— chronic bronchitis — but which more frequently oc- 
curs in elderly persons, is curable also by removal to 
a mild and equable climate, while it is generally re- 
fractory to all other medication. 

Scrofula, a taint in the blood of distressing preva- 
lence, especially among our city population, is often 
eradicated from the system by a total change of air, 
diet, and surroundings. The same is true in chronic 
rheumatism, dyspepsia, and nervous exhaustion. 

There is a period in advanced life when, though no 
actual disease is present, yet the bodily powers visibly 
give way to the advances of age. The mind, too, 
sympathizes and loses to some degree the keenness of 
the faculties. With most this is about the age of 
sixty. It has often been noticed how many men, 
inattentive to the signs of their failing powers and 
continuing to demand as much work of their weakened 
frames, suddenly die at this age. The part of pru- 
dence would be for them to take a complete and 



656 HYGIENIC MEANS OF CURE. 

prolonged rest, and to seek some mild and equable 
climate for a winter or two. This change, taken in 
time, will often add ten years to life. 

WHAT KIND OF CLIMATE TO CHOOSE ? 

This is a far more important and difficult question 
than is generally conceived. Not every person nor 
even every case of the same disease is benefited by 
the same climate. Unfortunately the invalid is apt to 
go where it is most convenient or most agreeable for 
him to go. Consequently he often fails in obtaining 
the improvement he expected, and which he would 
have experienced had he chosen more wisely. 

Some climates are sedative and relaxing, others 
tonic and bracing, some are moist and warm, others 
dry and cold; yet they may all be suited to certain 
persons and to certain complaints. There are some 
characteristics, however, which are indispensable to a 
healthy climate. These are a freedom from miasmatic 
vapors such as cause fevers and similar disorders, and 
an equable temperature, that is, one in which the dif- 
ferences "between the warmth of day and night and 
one day and another, are not very marked, and where 
abrupt alternations of temperature do not occur. 

A considerable amount of moisture in the air is 
beneficial to patients who have irritable throat and 
lungs, but is not likely to prove of use to a rheumatic or 
gouty invalid. The decision between a warm and cold 
climate may generally be correctly made by observing 
one's own sensations. If one can bear cold without 



CHOICE OF A CLIMATE. 657 

«. 

much discomfort and without a disagreeable sensation 
of chilliness ; if one is habituated to out-door exercise 
in winter, and is not subject to catarrh and cough at 
that season ; if the general health is better in winter 
than in summer ; if heat produces much exhaustion ; 
and if there is a tendency to torpidity of the liver 
or "biliousness," the probability is that a dry cold 
climate like that of Minnesota would be more suitable 
than a warm and moist one like that of our extreme 
Southern States. Should the reverse of all this be 
true, the wiser plan is to obey these suggestions of 
nature, and seek that temperature in which one feels 
most comfortable. 



THE CLIMATES OF THE UXITED STATES. 

The States which border on the Atlantic Ocean, 
north of Florida, all have climates subject to sudden 
and considerable variation, and are in most localities 
damp and exposed to severe winds. On these 
accounts they are for consumptives and rheumatic 
persons the least healthful of any in the Union. 

West of the Appalachian Mountains the air is much 
drier, and increases in this quality the nearer we 
approach the great chain of the Rocky Mountains. As 
a consequence, it is often found that "moving out 
"West" exerts a most excellent effect on the health of 
those who, in their eastern homes, have been threatened 
with attacks of pulmonary troubles. On the Great 
Plains, which stretch eastwardly from the base of the 
Eocky Mountains, hardly any water falls, and though 

43 



658 HYGMENTC MEANS OF CURE. 

the herbage is scanty and the soil thin, they offer a 
salubrious home for thousands who, in the dampness 
of our eastern seasons, would certainly die young. 

Although in the Mississippi Valley the winters are 
colder and the summers hotter than in the same 
latitude on the Atlantic coast, yet the daily changes 
are not so great, and the atmosphere is as a rule much 
drier. In the more southern portion of this immense 
valley, the extensive swamp land and the heat combine 
to render it unheal thful, much fever and ague and 
allied disease prevailing. But in the north the soil is 
higher and drier, the temperature lower, and the con- 
ditions generally more favorable to health. "Wisconsin 
and Minnesota enjoy a wide-spread fame for their 
salubrious winters. They are indeed cold, much 
colder than the eastern seaboard, the snow covering 
the ground for four months, and the mercury frequently 
10° and 20° below zero. But they are 

" Like a lusty winter, 
Frosty but kindly." 

Even tender invalids, to whom the raw air of 
Boston, New York, or Philadelphia is absolutely 
painful, can expose themselves to the dry cold of the 
northwest for hours with comfort and benefit. St. 
Paul, in Minnesota, has been the most popular health 
resort of the State. But it enjoys no advantages, 
except facility of access, over many other parts of that 
and neighboring States. 

For consumptives who are best suited with a cold 
climate, a region even more promising than Minnesota 






THE CLIMATE OF THE WEST. 659 

is the great interior plateau which lies between the 
Rocky Mountains on the east and the Sierra Nevada 
on the west, a vast plain elevated from six thousand 
to nine thousand feet above the level of the sea, and 
intersected by numerous mountain chains reaching 
into the regions of perpetual snow. Its winds in 
summer are easterly, and in winter variable. Drought 
prevails throughout the year, for the easterly summer 
winds bring no rain, as they are portions of the 
tropical trade-winds, and those from the Pacific on 
the west are deprived of their moisture in crossing 
the elevated peaks of the Sierra Nevada. This region, 
therefore, which is the most famous mineral district 
of our country, has all the requisites of a model 
climate for those afflicted with pulmonary disease. It 
corresponds in North America to the lofty table-lands 
of Bolivia in South America, in the arid slopes of 
which consumption is a disease unknown. 

THE MOST HEALTHFUL WARM CLIMATE. 

As we have said, very many patients, indeed we 
believe the decided majority of those who require 
change of climate, will be more benefited by a warm 
than a cold winter climate. It is, then, of even more 
importance to discover one which will combine the 
most numerous advantages with the fewest drawbacks. 
In doing so we shall as before confine ourselves to 
our own country, as those who propose a journey to 
Europe or the tropics for this purpose can readily find 
abundant sources of information elsewhere. 



660 HYGIENIC MEANS OF CURE. 

There are only three localities between which we 
need trouble ourselves to choose; the uplands of 
South Carolina, the peninsula of Florida, and southern 
Texas. 

The uplands of South Carolina have cool, dry, and 
bracing winters. The soil is light, and covered with 
pine and hard-wood forests. The water is pure, and 
the accommodations for invalids, at several points, 
especially Aiken, if not all that can be desired, yet 
much better than are often found. At this town, 
which is a thriving place of about fifteen hundred 
inhabitants, the surface is six hundred feet above sea 
level. The mean annual temperature is 62° Fahr., 
while the mean temperature of December, January, 
and February is from 45° to 50°. Frosts commence 
about the middle of November, and cease about the 
middle of March. The winter winds are from the east 
and north, but bring no rain. Malarial diseases are 
unknown at any season of the year. Such a climate 
is exceedingly well adapted to those who would find 
the severe dry cold of Minnesota irritating, the damp 
cold of the northern Atlantic States painful and 
depressing, and the moist warmth of Florida debili- 
tating. 

Florida is of all parts of our country that most visited 
for purposes of health. It is said that twenty thousand 
people seek it every winter with this object in view. 
Its climate has been studied with especial reference 
to salubrity by several able medical writers, among 
whom we may mention Dr. D. G. Brinton, of Phila- 
delphia, whose admirable little book, "Florida and the 



THE CLIMATE OF FLORIDA. 661 

SontJi" recently published, is the principal source to 
which we are indebted for the facts concerning it. 

The model warm climate for invalids must satisfy 
four conditions: it must have an equable temperature, 
moderate moisture, moderate and regular winds, and 
freedom from local diseases. There should be no 
sudden transitions from cold to heat, and the heat 
should not be excessive, not above 75° Fahr., as other- 
wise it will prove enervating to many constitutions. 

Southern Florida undoubtedly meets these require- 
ments more completely than any other portion of our 
country, broad as it is. The temperature of the 
winter months averages from 60° to 70°, frost and ice 
are entirely unknown, and the cold north gales of the 
higher latitudes are tempered to bland winds by the 
time they reach this favored region. The air is moist 
and soothing, laden with the healthy aroma of the 
sea, and the balsamic fragrance of the pine forests. 
Although in the interior swamp fevers are common 
in the early autumn, this is not the case in winter, 
and on the sea-shore and numerous islands they are 
altogether unknown. The warmest climate of the 
United States is on the southeastern extremity of 
Florida, near the Miami River. It is also the most 
equable and the most healthful. The reports of the 
surgeons of the United States Army unanimously 
speak of it as by far the most favorable in this respect 
of any in our territory. It much surpasses that on 
the banks of the St. John's River, which is and has 
been that most frequently chosen by invalids. 

Southern Texas has also often been mentioned with 



662 HYGIENIC MEANS OF CURE. 

i « 

praise in this connection. It is less warm, somewhat 
more variable, and with a drier air than Florida. 
Those who require a warm and dry rather than a 
warm and moist climate will do well to give it the 
preference. The winter temperature of Corpus Christi, 
Texas, is about that of Jacksonville in Florida, and 
considerably cooler than Key "West. It is also, 
though in the hottest district of Texas, subject to 
cold gales, called "northers," quite trying to delicate 
lungs. 

GENERAL. DIRECTIONS IN CHANGING CLIMATE. 

"Whatever climate is decided upon, let no one ima- 
gine that merely by going thither he is straightway to 
throw off his load of ills and return restored. There 
are no known Fountains of Youth, by bathing in which 
we can bring back the vigor of youth and wash off 
all our maladies. We must assist and supplement the 
restorative powers of climate by scrupulously observing 
numerous rules of hygiene, both mental and physical. 

In the first place, we should diminish to the utmost 
in our journey thither the discomforts and annoyances 
of travelling, trying enough to the well, seriously inju- 
rious to the sick. The journey should be broken by 
frequent rests, the mind kept placid by the sight of 
entertaining objects, and by judicious arrangements. 
The meals should be taken at regular hours, and in 
quantity and quality differ as little as possible from 
those to which the invalid has been accustomed. The 
sleep should likewise be regular and unbroken, and, 




No. 6 (p. 670). 

To face p. 663. 



No. 8 (p. 671). Lifting Cure (p. 671). 



PRECAUTIONS IN CHANGING CLIMATE. 



663 



therefore, night travelling be avoided. The night air 
should always be shunned, and excess of any hind 
absolutely interdicted. The clothing should be of 
wool, and sufficient to guard against any chilliness. 
Moderate and regular exercise should be sought when- 
ever possible. The bowels should be maintained regu- 
lar by some gentle laxative, such as we shall mention 
on a later page. 

The first effect of a warm climate on many constitu- 
tions is to bring on a " bilious" attack, characterized 
by headache, sick stomach, slight fever, and diarrhoea 
for a few days. It can best be avoided by a sparing 
diet, by avoiding fatigue, the rays of the sun, and in- 
dulgence in fruit or spirituous liquors. The treat- 
ment is rest in bed, some citrate of magnesia or other 
cooling laxative, and a low diet. 



THE SWTEDISH MOVEMENT CURE. 

An eccentric but learned Swede, by name Ling, in 
the early part of this century invented a series of 
movements, to be performed with the aid of an as- 
sistant, which were to exert a curative effect on 
diseases. Since his death his plan has been extended 
and carried out with great success in various parts of 
Europe, while in this country it has been introduced 
and popularized by Dr. Charles F. Taylor, of New 
York. 

Its application is limited to diseases of a chronic 
character, where there is no inflammation or irritation, 
and especially to those which are dependent upon a 



664 HYGIENIC MEANS OF CURE. 

want of proper circulation of the blood. In many of 
these it is exceedingly efficient, surpassing any other 
means within the scope of medical art. We shall 
explain and illustrate its application in several of the 
most common diseases in which its value has proved 
most conspicuous. 

The theory of the movement cure, its "first and last 
object," to quote Dr. Taylor's expression, is to secure 
a proper circulation of the blood. When this is 
secured, in many cases there will be no further need of 
medical aid. To accomplish it, a very varied series 
of movements of every part of the body has been 
planned, such as bring every muscle into action, and 
draw to that part, consequently, an unusual flow of 
blood. These movements can be made by a person 
alone, but are more certainly efficacious when aid is 
rendered by an assistant, and their exact character and 
sequence superintended by one skilled in the anatomy 
of the body. 

It is a common error to suppose that in order to 
derive benefit from exercise it must be carried to the 
point of fatigue. So far is this from being the case, 
that in persons whose systems have reached a certain 
stage of exhaustion any fatigue whatever is always 
injurious. Indeed, as a general rule, persons who are 
in feeble health should never fatigue themselves. In 
taking exercise, they should always stop short of that 
point. For this -class the localized movements are 
admirably suited. They impart all the advantages of 
exercise and escape its drawbacks. 

Any one who has frequented a gymnasium will 



THE MOVEMENT CURE. 665 

have observed that feeble persons, instead of becoming 
flushed, heated, and finally tired by exercise, turn pale 
and complain of trembling and exhaustion, passing 
even to faintness. This shows that their exercise is 
not suited to them, and instead of increasing their 
vigor, will certainly injure them. ISTo one should 
continue when thus affected, but should choose lighter 
and less-prolonged modes of exertion. Whatever 
exercise is adopted, its early and permanent effect 
should be to cause a rush of blood to the extremities, 
to heighten the color in the cheeks, and to warm the 
hands and feet. There should be no palpitation of 
the heart, shortness of breath, or nervous exhaustion. 
"What the movement cure aims at is to provide this 
kind of exercise, so gently graduated that the invalid 
who cannot leave his couch can yet enjoy the benefits 
of it. This it successfully accomplishes. 



MOVEMENTS FOR COLD HANDS AND EEET. 

The most common sign of a want of proper circula- 
tion is a constant tendency to cold hands and feet. 
These extremities feel cold and damp to the touch, 
and suffer much in cold weather. The remedy for this 
is to flex and extend the various joints of the extremi- 
ties in a slow and uniform manner, the force being 
increased by being resisted by an assistant. Even 
entirely passive movements, that is, those made by the 
assistant manipulating the extremities, have a like 
effect. It is important to remember that these, and 
all the movements used in this system, must be 



666 HYGIENIC MEANS OF CURE. 

repeated slowly and evenly for five or ten consecutive 
times to have the desired effect. 

The accompanying illustrations, which we borrow 
from the excellent work of Dr. Taylor on the Move- 
ment Cure, will exemplify some of the motions which 
are adapted to relieve the trouble of which we are 
speaking. 

In the movement here represented, the patient 
reclines on a seat with a movable back, with his leg 
and foot in the lap of an assistant. The latter places 
the palm of his hand on the toes, and moves them 
around in a circle, so that all the muscles and tissues 
are put in rotation quite up to the knees. Let those 
who are suffering from cold feet have this move- 
ment practised upon them for a few minutes, and 
they will soon convince themselves of the efficacy of 
the movement cure. They will experience not only 
an agreeable sensation of warmth in the feet, but a 
general feeling of comfort, extending throughout the 
whole body, due to the relief of congestion of all the 
internal organs. The test is so simple, that we urge 
all of our readers to try it the first time their feet are 
unpleasantly cold. 

Another movement of similar effect is for the 
patient, in the same position, to extend the foot very 
steadily and slowly against the resistance of his 
assistant, and then the latter to take the foot and bend 
it forcibly against the resistance of the patient. "When 
this is repeated a dozen times, the foot will usually be 
found comfortably warm. The same motion can be 
made with the knee-joint, with equally satisfactory 



THE MOVEMENT CURE. 667 

results. It is like putting the leg in a warm bath. 
The application of a similar movement to the hand 
and the forearm will readily be understood without 
special instructions. 

When it is desired to cause a gentle flow of blood 
to all the extremities, one of the best movements is 
that represented in the sketch (No. 2). 

The invalid, it will be observed, takes hold of a hori- 
zontal pole a few inches higher than the head, and cour- 
tesies down till his arms are straight, where he hangs 
a few moments, and then slowly straightening the legs, 
rises into the first position again. This, like all other 
movements, should be repeated, with regularity, eight 
to ten times. It requires slight effort, and causes a 
very decided flow of blood to both arms and legs. 

A third movement, which brings the blood to the 
external muscles over the whole body, and admirably 
relieves all internal congestions, is shown in the cut 
(No. 3). 

This represents a person hanging by the hands to a 
horizontal pole. The legs are to be extended from a to 
5, against the efforts of an assistant, and then brought 
back into contact against similar resistance. The re- 
sult of this is that not only the legs and arms, but the 
whole lateral and external muscles of the body, are put 
upon the stretch, and a most agreeable glow, and feel- 
ing of lightness and relief, are extended throughout 
the whole body. 



668 HYGIENIC MEANS OF CURE. 

MOVEMENTS FOR CONSTIPATION OF THE BOWELS. 

This is a complaint to which those especially are 
subject whose occupation obliges them to remain in a 
sitting posture most of the day. It is not only annoy- 
ing in itself, but paves the way for the entrance of a 
multitude of maladies. Every care should be taken 
not to allow it to progress this far. Of the means of 
relief, there is probably none at once more efficacious, 
more durable, and more convenient than a judicious 
system of movements. 

What is required is a more decided flow of blood to 
the bowels and the muscles which cover them. This 
will increase their life and their activity, and effectu- 
ally dispel their sluggishness. "We must not depend 
upon drugs which artificially excite the bowels, and 
leave them afterwards in precisely the same state they 
were before, nor yet on injections which mechanically 
wash out their contents, yet do not furnish the first 
condition for a new, healthy action. We must aim, on 
the contrary, to mechanically agitate the contents of 
the bowels, to bring a strong flow of blood to them, and 
give them the necessary elements of health. This we 
can do by judicious movements impressed upon them. 
One of these is represented in the cut (No. 4). 

Here we see the patient kneeling upon a bench, his 
hands over his head. An assistant places his knee 
against the buttocks, seizes the extended hands, draws 
them slowly but firmly back, and then pushes them 
forward, always against the patient's resistance. The 
same motion may be made forward and sideways. 



THE MOVEMENT CUKE. 669 

Thus all the muscles of the abdomen are put upon the 
stretch, the blood called to them, and the bowels with 
their contents agitated. 

Or a position can be assumed upon a table as in the 
figure No. 5. The assistant seizes the ankles and 
presses them down from a to 6, then brings them to a 
horizontal position and elevates them or moves them 
sideways, as usual, against resistance. This expands 
the front of the whole body, and acts especially upon 
the contents of the abdomen. 

The figure No. 6 shows another excellent movement 
for constipation. The invalid is fastened to the post 
by a strap around the hips, and an assistant lays hold 
of the shoulder and rotates the body in a circle (as 
represented by the dotted line), always in such a way 
that the trunk is carried back of the perpendicular, 
and the motion is through the abdomen. 

Persons who have long been in the habit of depend- 
ing upon injections to secure a regular movement of 
the bowels, will find this movement peculiarly adapted 
to their cases. 

Another and valuable series of motions to the 
abdomen can be imparted by an assistant steadily and 
gently kneading the abdomen. The patient lies upon a 
couch or bench, slightly elevated at the head, and with 
or without the knees drawn up. 

The pressure should be made in the course of the 
bowels, and should not be a series of pushes, but rather 
a series of sudden shakes and vibrations. 



670 HYGIENIC MEANS OF CURE. 



MOVEMENTS FOR DYSPEPSIA. 

This malady is so frequent, and presents so many 
different features, that it is difficult and well-nigh im- 
possible to suggest any treatment which will suit a 
very large majority of cases. A few hints, so far as 
the movement cure is concerned, are all we can give. 
"Whenever there is tenderness on pressure over the 
stomach or abdomen, the movements should be very 
gentle, and confined to the extremities ; when there is 
no such tenderness, they should be more decided, and 
act on the muscles in and over the stomach. 

The gentle kneading of the stomach, with the knee 
drawn up, which we have recommended above for con- 
stipation, will be found of service. So, also, if the 
patient sit with feet extended, and one hand above his 
head, so as to put the abdominal muscles on the stretch, 
and an assistant place a hand just below the ribs, and 
press upward and inward, with a vibratory motion, an 
excellent stimulating effect will be accomplished. 

Another, more powerful, movement can be executed 
on the horizontal bar. The bar is just above the head 
of the patient. He graps it with both hands, about a 
foot apart, and swings himself slowly in a circle, or 
bends from side to side, preferably against the resist- 
ing hand of an assistant. 

The centre of motion is the stomach or abdomen, 
and the result is a decided flow of blood to the part. 

Or, standing firm, the body can be bent forward and 
backward, to the left and the right side, the hips 



THE MOVEMENT CUBE. 671 

remaining immovable, and the abdomen being the 
fulcrum. The result is similar to the foregoing move- 
ment, and they can with benefit be alternated. 

The above description will sufficiently indicate the 
character of the movement cure, and its adaptation to 
several of the most frequent complaints, in those 
especially for which it is best suited. It is also of 
service in spinal deformities, pulmonary consumption, 
and diseases of women, but we do not consider it of 
so much value in these, except perhaps the former, as 
in those we have described. 

Chronic diseases only are to be treated by it, and 
its action is slow and the movements must generally 
be regulated by some one who is versed in anatomy. 
Those we have given, however, are simple, and may 
be put into practice by any one. Relief must not be 
expected immediately, as the good results of the treat- 
ment are visible only after it has been instituted some 
weeks or even months. But when it does arrive, it is 
permanent and complete. 



THE LIFTING CURE. 

One of the branches of the movement treatment is 
the so-called "lifting cure." It has been tried within 
the last few years by many persons suffering with 
general debility and various chronic complaints, with 
good success. 

As its name implies, it is a lifting exercise, very 
light at first, if the patient be much debilitated, and 



672 HYGIENIC MEANS OF CURE. 

very gradually increased with the improvement in 
health and strength of the patient. 

The point is to secure longitudinal pressure upon 
the spinal column without shock. The apparatus 
employed is therefore so constructed as to prevent the 
weight being lifted all at once, the full exertion being 
only applied at the end of the lift, and the power 
exerted being gradually increased from the first 
beginning of the effort, till the weight is raised, when 
the effort is sustained uniformly for a few seconds, in 
holding the weight suspended, and then gradually 
diminished to the end. The patient then rests for a 
short time, alternately lifting and resting until the 
exercise is completed. Thus, neither shock nor sudden 
strain is possible, no matter how great the exertion 
may be. 

Several different machines designed to secure these 
objects can be purchased in any of our principal cities. 
We do not know that either has decided advantages 
over the others. We append a sketch of one of them, 
which will give an idea of their construction. 

ELECTRICITY. 

Ever since the invention of the "Leyden jar," a 
century ago, by which the electric spark can be so 
readily displayed, there have been constant attempts to 
apply it as a curative agent. So familiar has this 
powerful and mysterious agent become, that we can 
dispense with a description of its varieties and how 
they are generated. Its forcible effect upon the nerves 



TREATMENT BY ELECTRICITY. 673 

when a "shock" is received, would seem to promise 
not less striking results when applied to various dis- 
eased conditions. And, moreover, there have not been 
wanting authentic examples where even so violent a 
dose as that received from a stroke of lightning has 
resulted in the cure of long-standing palsies and deaf 
ness. 

Every instrument-maker nowadays keeps on hand 
some of the many apparatuses designed to apply elec- 
tricity to medical use. These are generally of one of 
three forms: either the electric fluid is developed by 
turning a crank — magneto-electric machines; or it is 
generated by the chemical action of two plates of metal 
immersed in a cup containing an acid solution, and 
by an artificial magnet — electro-magnetic machines; 
or they consist of plates of different metals fastened 
together, which evolve a small amount of electricity 
by acting upon each other — electric disks, chains, 
rings, etc. Of these, the first mentioned are the most 
convenient, the second the most efficient and manage- 
able, the third the most feeble and uncertain. Those 
who have used this agent most extensively are by no 
means of one opinion as to which of the two first- 
mentioned varieties act more satisfactorily, though the 
tide seems turning in favor of electro-magnetic ma- 
chines, several of which of great ingenuity and sim- 
plicity are manufactured. 

Most of these machines when sold are accompanied 
by pamphlets describing their construction, and giving 
rules for their use in diseases. But it is well to learn 
the general principles of employing this potent agent 

43 



674 HYGIENIC MEANS OF CURE. 

from some more reliable source than a dealer's pam- 
phlet. 

HOW TO APPLY ELECTRICITY. 

Every apparatus furnishes a positive and negative 
current. Each is conducted from the positive or nega- 
tive pole of the instrument by a flexible metallic cord, 
to the free end of which an "excitor" is attached. 
The excitors vary in form and size according to the 
object to be accomplished. Some are thin metal plates 
for applying over the surface of the skin ; others are 
pointed or olive-shaped, to excite the deeper muscles. 
Hollow cylinders containing moistened sponges are 
sometimes used. Another excitor is a brush of fine 
wires, or of camel-hairs. Or, instead of an artificial 
excitor, the hand of the operator may be employed. 

In the latter manoeuvre, one pole, usual ly the nega- 
tive, is adjusted to some portion of the patient's body 
possessing but little sensibility, while the other is held 
by the operator, who, having dried the skin perfectly, 
passes the back of his hand over the portions of the 
surface he wishes to stimulate. If the current is 
strong, this will produce a sharp, stinging sensation, 
and if continued, will produce a marked redness last- 
ing some minutes. 

The process called "general electrization" is similar 
to this. The patient seated, places his feet on a metal 
plate connected with the negative pole of the instru- 
ment, while the operator, taking hold of the positive 
cord, passes his disengaged hand over the whole sur- 
face of the body, thus stimulating the skin in all 



USES OF ELECTRICITY. 675 

parts. This is claimed to have a peculiarly bracing 
and invigorating effect. Such a sitting should last 
about fifteen minutes, and be repeated daily or every 
other day. 

The direction of the current influences decidedly 
the sensation produced. As a rule, the negative pole 
should be placed more toward the extremities and the 
positive more toward the central portions of the body ; 
in other words, and to speak more accurately, the 
current should be made to traverse the nerves in their 
course from the centre to the extremities. A current in 
the direction of the nerves is soothing and strengthen- 
ing ; and one in the reverse direction is exciting and 
stimulating. Hence both have their appropriate uses. 

DISEASES BENEFITED BY ELECTRICITY. 

There are in all cities pretenders to medical science 
who set up to cure all diseases by electricity. Such 
may always be confidently held to be impostors. 
Neither this nor any other agent is a panacea. There 
are many complaints, especially those of a chronic 
character, in which it is available ; while there are 
many others in which it is wholly useless or positively 
injurious. 

To commence with one in which its curative powers 
are strongly displayed, we mention palsy. When this 
does not depend on some actual organic change in the 
brain or spinal column, it promises favorably under 
electrical treatment. Such cases, for example, as fol- 
low from inflammation of a joint, blows, burns, rheu- 



676 HYGIENIC MEANS OF CURE. 

matism, typhoid fever, diphtheria, etc., will generally 
yield wholly or partly to the regular application of 
the electric current over and through the affected 
muscles. 

In lead-palsy r , or that which results from the system 
being poisoned with lead, the muscles of the arm are 
affected in such a manner that the hands droop, and 
the peculiarity is presented called "dropped wrist." 
Sometimes the lower extremities are affected, and in a 
few cases the palsy extends over the whole system. 
These cases are especially benefited by electricity, 
and they are most rapidly stimulated by using various 
currents, and by passing them in both directions. 

ELECTRICITY FOR LOSS OF VOICE. 

The loss of voice which occurs after prolonged sing- 
ing or public speaking, and from various excitability, 
the inordinate use of tobacco, chronic bronchitis etc., 
has been successfully treated by electricity. The 
current is passed from the neck to the throat and 
chest, and from one side of the neck to the other. 
Sometimes a single application will restore the voice 
when the patient has not been able to speak above a 
whisper for years ; but generally the daily use of the 
battery for three or four weeks is required in order to 
complete the cure. 

ELECTRICITY FOR THE SPECIAL SENSES. 

When blindness depends upon a deficiency of 
nervous power, it may be relieved by the use of the 



USES OF ELECTRICITY. 677 

current. One of the excitor s, the positive one, may 
be placed in the mouth, and the other beneath the eye ; 
or one on one temple, and one on the other ; or the 
positive excitor may be pressed against the back of 
the head, and the negative, tipped with a wet sponge, 
over or against the eye. In many cases of simple 
weakness of the eyes, and when they are fatigued from 
over-exertion, the application of weak currents from 
the back of the neck to the eyes, using an eye-cup 
filled with water and connected with the negative pole, 
produces a feeling of relief and stimulation. A dread 
of light, and pain on exposure to it, are frequently 
relieved by such a current passed through the hand 
or a soft brush, from the forehead and eyes to the neck 
and shoulders. 

Many cases of deafness can be treated with the best 
results by electrization. This is best accomplished by 
half filling the ear with water and introducing the 
negative excitor, while the positive one is placed on 
the nape of the neck. A very weak current should be 
used at the commencement, and be increased as it is 
found necessary. 

Loss of the smell is not a common affection, but is 
sufficiently annoying to lead those who suffer from it to 
seek relief. Persistent electrization has been known 
to cure obstinate cases, and may be used with good 
prospects. 



678 HYGIENIC MEANS OF CURE. 

ELECTRICITY FOR NEURALGIA, POISONING, AND 
RHEUMATISM. 

Neuralgia will be benefited by electricity when it 
does not arise from a change in the structure of the 
nerve itself. The current should be steadily applied, 
gradually increased as the patient will bear it, and 
generally in a downward direction. Occasionally the 
relief will be almost instantaneous, and if the case be 
of recent origin, will continue well. If of long stand- 
ing, the treatment will have to be persevered in, and 
even prolonged after the patient is apparently cured, 
to prevent the pain from recurring. 

In opium-poisont7ig, when the patient is in a pro- 
found sleep and cannot be roused by other means, he 
will sometimes respond to the electrical current. A 
child five days old had taken two drops of laudanum 
by mistake; ten hours afterwards, when the child had 
been pronounced beyond the reach of human aid, 
electricity was applied to keep up the breathing, and 
shocks were passed from one nipple to the other, and 
in other directions, to arouse it thoroughly. After ten 
hours' unceasing exertions the child was sufficiently 
recovered to be intrusted entirely to its mother. 

The same persistent use of this agent is often the 
only successful resource in eases of persons who have 
been reduced to a condition of apparent death or 
insensibility by drowning, carbonic acid fumes, etc. 
It must be persevered in for a long time, and not to 
the neglect of friction, artificial respiration, and other 
well-approved means of resuscitation. 



USES OF ELECTRICITY. 



679 



Chronic rheumatism, stiff joints, and want of action 
of the muscles of the limbs, are often materially 
relieved by the judicious employment of a battery. 
Generally debility and want of tone in the system 
respond most readily to general electrization, as 
already described. Certain kinds of tumors and swell- 
ings will disappear under the long-continued action 
of the current. Old ulcers sometimes heal under a 
similar influence. Impotence and debility of the 
reproductive powers can frequently be cured. And 
one of the best hair tonics is stimulation of the scalp 
by the use of the excitors. 





CHAPTEE IT. 



ON MEDICINES. 



What are medicines? — Sources from which medicines are derived — How 
medicines act — The various ways in which medicines are given — The 
forms in which medicines are dispensed — Medical weights and measures — 
What "domestic medicines" properly are. 

Section I. The Medical Properties of Common Articles. Alcohol 
and alcoholic liquors — Alum — Borax — Coal oil — Charcoal — Common salt — 
Cream of tartar — Ginger — Lemon juice — Lime — Mustard — Olive oil — Bed 
pepper — Saltpetre or nitre — Soda — Sulphur — Tar — Turpentine — Yinegar — 
Water. 

Section II. The Medical Properties of Domestic Plants. When and 
how to gather medicinal plants. 

1st. Trees and Shrubs. American poplar — Bear-berry — Black elder — Black- 
berry — Burdock — Cleavers, or goose-grass — Dogwood — Juniper— Oak bark 
— Persimmon — Poke-weed — Sassafras — White walnut — Wild cherry — 
Willow. 

2d. Herbs and Plants. Calamus — Dandelion — Flaxseed — Fleabane — Garlic 
— Hops — Horseradish — Lettuce — Lobelia — Parsley — Peppermint — May- 
apple — Sage — Seneka snakeroo.t — Thorn-apple — Tansy — Virginia snake- 
root — Wormseed. 

Section III. The more Important Chemical and Foreign Drugs. 

1st. Vegetable Drugs. Aloes — Assafcetida — Camphor — Castor oil — Jalap — 
Ipecac — Opium — Peruvian bark and quinine — Rhubarb — Senna. 

2d. Mineral and Chemical Drugs. Bromide of potassium — Calomel — Carbo- 
lic acid — Chloral — Chlorate of potash — Iron — Magnesia — Sugar of lead — 
Epsom salts. 




HE various means for treating diseases which 
we have hitherto spoken of as furnished by 
nature and by mechanical ingenuity are all useful, 

( 680 ) 



FOOLISH PREJUDICES AGAIXST DRUGS. 681 

but are all subordinate and secondary to medicines. 
These are, after all, our most convenient, potent, and 
valuable weapons wherewith to combat the inroads of 
sickness. There are, however, some prevailing preju- 
dices and misunderstandings about them of which we 
wish to disabuse our readers. So we will first inquire 

WHAT ARE MEDICINES? 

In a general and broad sense, they are whatever 
substances are used for the cure of disease. 

It is a foolish idea to suppose that a medicine is 
something which is always offensive to the senses or 
distressing in its operation, or something which can- 
not be found outside of an apothecary-shop. So far 
from this being the case, some of the most efficient 
medicines are articles of daily food, as salt, sugar, and 
milk; others are looked upon as luxuries, for a plate 
of ice-cream or a glass of champagne is at times 
just as truly a medicine as a dose of salts and senna 
or calomel and jalap. The absurdity of those who 
inveigh against the use of "drugs" is plain enough 
when we remember that these very drugs are often 
prized as condiments, spices, and food where they are 
produced. Tobacco, the hop, ginger, and blackberries 
are drugs in so far as they are medicines ; but plenty 
of people use them who are not asked to do so by 
their doctor. 

Another unworthy and absurd prejudice exists 
against drugs because they are "poisons." ISTow, it 
is very true that many medicinal substances are poi- 



682 ON MEDICINES. 

sonous, if taken in improper quantities. But so is 
everything else. Pure cold water, swallowed by a 
person in a heat, has been known to kill as instanta- 
neously as prussic acid. The rays of the sun, w^hich 
give life to nature, destroy every summer many a 
victim as swiftly as the most fatal contents of the 
chemist's vials. It is almost a law of nature that 
whatever is capable of destroying life can, in a certain 
less amount, under given circumstances, save life. 
The capacity for good equals the capacity for evil. 
All that is required is the intelligent mind to discern 
when the need exists, and the skilful hand to measure 
and administer the proper quantity. 

Those who declaim against the use of drugs, while 
yet they do not hesitate to use cold water and mustard, 
and such simple remedies, merely betray a timidity 
which arises from ignorance; for to the trained 
physician there is not a particle more danger in pre- 
scribing strychnine and arsenic than the simplest 
household recipe. 

SOURCES FROM WHICH MEDICINES ARE DERIVED. 

Every realm of nature contributes something fraught 
with healing virtues to the human race; and he has 
little thankfulness in his heart toward a beneficent 
Providence who doubts the propriety of using any of 
them. Foolish people object to "mineral" medicines; 
as if our Divine Creator had issued a mandate that 
the mineral kingdom should furnish no substance 
" with healing in its bosom," but only vegetable and 



THE VALUE OF MINERAL MEDICINES. 683 

animal products should be thus endowed; as if 
minerals, such as salt, iron, and lime, do not consti- 
tute a part and an indispensable part of our daily 
food; as if, finally, Nature herself does not prepare, 
under the form of mineral waters, skilfully compounded 
mixtures of world-renowned efficacy. Nothing can be 
more contrary to common-sense, daily experience, and 
a proper conception of the celestial government, than 
the theories and assertions put forward by the "herb 
doctors," so numerous in some parts of our country. 

The vegetable, the mineral, and the animal kingdoms 
all furnish us with medicines. They seldom exist in 
a pure and separated state, but are to be extracted 
from the substance in which they are found, by human 
art. This is pharmacy, the art and business of the 
apothecary and druggist. 

The majority of medicines come from the tropics, 
but there is no zone in which medicinal substances do 
not occur. The root, bark, leaves, and flowers of 
plants, the chemical combinations of the metals, and 
the secretions and bodies of animals, exert definite 
actions on our bodies, which we can take advantage 
of to expel diseases and restore health. 



HOW MEDICINES ACT. 

Most persons who have not given any particular 
thought to the subject imagine that medicines act by 
a special power of curing a given disease. They ask 
from the physician what will cure pleurisy or typhoid 
fever. 



684 ON MEDICINES. 

Now, there are very few remedies which act in this 
way— not more than half a dozen in all, perhaps. 
They are known as " specifics," and heal by virtue of 
powers which we cannot explain. They seem to act 
as an antidote acts on a poison. Quinine is such a 
specific in fever and ague, colchicum in gout, iodine 
in goitre, and there are one or two more. 

But the vast majority of medicines are not remedies 
for diseases , but for symptoms — that is, for unhealthy 
conditions of the system which reappear in similar 
form, only differently grouped, in a vast variety of dis- 
eases. For instance, costiveness is a symptom which 
is found in very many complaints; feverishness is 
another; sleeplessness another; debility another; pain 
another; diarrhoea another; and cough another. All 
these may appear in the course of the same complaint, 
as in typhoid fever for example, and our medicines 
must be directed against them, not against the dis- 
eases. This is called "treating by symptoms," and in 
ninety-nine cases out of a hundred it is all we can do. 

MEDICINES CLASSIFIED. 

On this account medicines are classified according 
to what symptoms they are adapted to overcome; and 
in works on materia medica drugs are arranged under 
such classes. 

There are no great number of symptoms, and a very 
few minutes' study is sufficient to master all the more 
important divisions of drugs, and to understand the 
terms which are applied to them. 



HOW MEDICINES ARE CLASSIFIED. 685 

An anodyne is a medicine which relieves pain, 
soothes the system, and induces sleep; for instance, 
opium or chloral. 

An anaesthetic carries the soothing influence to the 
extent of complete insensibility, even to severely pain- 
ful impressions; as ether and chloroform. 

An astringent binds the bowels and checks the 
natural discharges. 

A cathartic, purgative, or laxative has precisely the 
opposite effect, loosening the bowels, and leading to 
diarrhoea. 

An emetic produces vomiting, causing the stomach 
to reject its contents. 

An expectorant loosens a cough, aiding the lungs to 
throw off the phlegm and mucus which collect in 
them when inflamed. 

A stimulant excites promptly the whole system for 
a short time, but has a merely temporary effect. 

A tonic strengthens the system gradually but per- 
manently, increasing the appetite, and aiding diges- 
tion. 

A febrifuge lessens the heat of the skin and other 
symptoms of fever. 

A diuretic acts upon the kidneys, causing a freer 
flow of urine from the bladder. 

A diaphoretic increases the perspiration, causing an 
augmented now of sweat from the skin. 

Many medicines exert several of these effects at the 
same time; and some act differently, depending on the 
circumstances under which they are taken. Thus 
some diaphoretics will act as such if, after taking 



686 ON MEDICINES. 

them, the patient remains quiet and dresses warmly; 
but if he walk about in a cool air, they will exert their 
action on the kidneys, and thus become diuretics. 

As the number of symptoms is quite limited and 
readily recognized, it can now be understood how, 
with a few active remedies, one of each of the above 
classes, and two or three specifics added, a person 
may be prepared to render efficient aid in relieving the 
sick. 

It is of importance to make a judicious combina- 
tion of several drugs acting in a similar manner, as it 
has been found that the effect is much more salutary. 
Hence the value of well-selected recipes, and hence 
the point of the anecdote often told of an eminent old 
physician, who remarked, "When I commenced prac- 
tice, I had twenty remedies for one disease, now I 
have one remedy for twenty diseases." What he 
wished to convey was that he had by long experience 
settled upon certain formulas as better than all others 
to combat certain symptoms. 

Not that we would have it supposed that the study 
of medicine is chiefly or even largely the study of 
medicines. This is an erroneous popular fallacy which 
we distinctly deny. The study of medicine is chiefly 
the study of disease, and it is this reason that renders 
it impossible for "every man to be his own physician." 
He must have experience in detecting the symptoms 
of sickness, and in recognizing their various compli- 
cations. This requires years of study. 



MODES OP ADMINISTERING REMEDIES. 687 



THE VARIOUS WAYS IN WHICH MEDICINES ARE GIVEN. 

Usually, medicines are given by the mouth; but 
this is by no means the only way. Not unfrequently 
we wish a more direct effect than can be produced 
through the medium of the stomach, and consequently 
they are applied directly to the spot affected. This 
may be accomplished by several methods. 

For the interior of the throat, we use a gargle; for 
the mouth, a wash; for the nostrils and lower bowel, 
an injection. The last mentioned is thrown up by 
means of a syringe, and can very frequently be re- 
sorted to with advantage, especially in young children. 

On infants, and persons of sensitive skin, anointing 
or "rubbing in" a medicine or placing it upon the skin 
is often efficient. Thus, instead of forcing a nauseous 
dose of castor oil down a baby's throat, it will act 
just as efficiently in the majority of cases to rub the 
oil well into the skin along the spine or over the 
stomach. Itch and many skin diseases require no 
other manner of administration. Anointing is also of 
value in erysipelas, scarlet fever, bruises, etc. This is 
called the "external" or outward application of medi- 
cines, and when put up for such uses, they form 
poultices, plasters, blisters, ointments, cerates, and 
liniments. 

Of recent years, a very small syringe with a needle- 
like point has been used to inject medicines under the 
skin. This is called the hypodermic method, but it is 
not one which can be introduced with advantage in 
the home treatment of disease. 



688 ON MEDICINES. 

Another plan, and a very efficient one in many dis- 
eases, is to have the patient breathe in a vapor charged 
with the properties of some medicinal substance. He 
then takes it into his lungs, whence it passes into the 
blood. This is a very ancient and approved method. 
Sometimes the evaporation alone of the substance is 
sufficient to impregnate the inspired air, as in the case 
of ether and chloroform; at other times it should be 
burned or heated, as in the use of tar vapor, resins, etc., 
and the smoke of tobacco, thorn-apple, nitre paper, 
etc. The steam from boiling water, either simple or 
with medicinal herbs, etc., added to it, can be very 
conveniently inhaled by pouring the water in a vessel, 
and making a large cornucopia of a newspaper, with 
a sufficient opening at the smaller end to allow it to 
receive the nose and mouth. 

Of late years liquids have been introduced into the 
air-passages in the form of a fine spray, and this 
method is called the " atomization" of fluids. Various 
instruments have been resorted to to facilitate this 
plan. The "hand-ball atomizer," in which a current of 
air is used as the means of reducing the liquid to a 
fine spray, is the simplest, and is very readily used by 
any person. By this means we can administer almost 
any medicine in solution, and bring it directly into 
contact with the interior of the throat and lungs. 

The method of inhalation is one which is deservedly 
popular, and is, as it were, recommended by Nature 
herself, for the remedies which she applies are often 
presented in this form. The balsamic atmosphere of 
the pine forests, the salt-laden air of the sea-shore, and 



FORMS OF ADMINISTRATION. 689 

the odorous and health-giving zephyr of the spring, 
all derive their salubrious properties from the invigo- 
rating substances in a state of minute division which 
they contain. 



THE FORMS IN" WHICH MEDICINES ARE DISPENSED. 

So far as the effect of a medicine is concerned, it 
makes little difference in what form it is given. That 
is merely a matter of the apothecary's art. The same 
drug can be put up in a liquid or a solid form — as a 
pill, a powder, or a solution. 

Certain forms are chosen as best adapted to admin- 
ister certain drugs, because a bad flavor is thus con- 
cealed, or because they are most easily put up. Some 
of the more important forms usually employed are as 
follows: — 

An infusion is a solution made either by pouring 
boiling water on a vegetable product, or steeping it 
for several hours (twelve to twenty-four) in cold 
water. In familiar language, it is a "tea." This is a 
popular and excellent mode of administering those 
medicines which yield their virtues readily to water. 
Most herbs, roots, and barks, both domestic and 
foreign, can thus be given. Infusions are, however, 
liable to spoil, and must be kept in a cool place, and 
frequently made afresh. 

Decoctions are solutions prepared by boiling the 
substance in water for a longer or shorter period. 
They are much less used than infusions, as there are 
few vegetable substances which will not yield their 

44 



690 ON MEDICINES. 

remedial principles to cold or boiling water poured 
upon them. Moreover, the virtues of many plants are 
destroyed by boiling, and their fine flavor is lost. 

Tinctures are solutions of medicinal substances in 
spirituous liquors. Alcohol, either diluted or not, is 
usually employed, but any of the strong liquors, such 
as whiskey, brandy, or rum, may be chosen. This is a 
favorite form for administering drugs. It presents 
their active principle in a small volume, it can be 
preserved unaltered for a long time, and it is well 
adapted to unite with other substances. It is, however, 
objectionable on the ground that if taken continuously 
it may create a fondness for alcoholic stimulants. 
Therefore, in domestic practice, we do not recom- 
mend it. 

The so-called fluid extracts are preferable. In these 
the active ingredients of medicines are concentrated 
into a small bulk in the liquid form by partially 
evaporating the expressed juices of the plants. They 
are convenient and elegant, and are now manufactured 
by a number of leading commercial firms in the United 
States. 

Solid extracts are formed when the juices of plants 
are evaporated so as to lose all or most of their fluid 
parts. They are generally of a soft consistence, a 
dark color, and a taste similar to that of the substance 
from which they are derived. Many of them, however, 
have much less strength than they should have, owing 
to want of care and skill in the evaporating process. 

Most extracts and other dry substances can be made 
into powders. This is done in a variety of ways, 



VALUE OF POWDETCS, 691 

generally either by grinding in a mill or by a mortar 
and pestle. Their general action is most marked 
when they are most finely divided. As most medi- 
cines can be brought to this condition without diffi- 
culty, and be preserved without losing their power, 
it offers the most portable, convenient, and safe form 
for their domestic use. The powders can be taken by 
mixing them in water, molasses, scraped apple, or any 
other vehicle, and are far more easily swallowed by the 
majority of persons than pills. They are not liable 
to breakage nor evaporation, as fluid preparations, and 
the dose can be measured with equal accuracy. 

Pills can readily be made from powders by adding 
a sufficient amount of gum, honey, or similar sub- 
stance to make a stiff paste, from which the pills are 
rolled by the fingers. Many substances, of which the 
dose is small, are conveniently administered in this 
form. Very small pills are called granules. 



MEDICAL WEIGHTS A^D MEASURES. 

In putting up medicines in the above forms, and 
generally in administering them, the greatest care is 
requisite to give enough, but not too much. An 
insufficient or an overdose will do no manner of good, 
and may result in serious mischief. A common notion 
prevails among ignorant people that if what they 
deem a small dose benefits them, a larger quantity 
should do a proportionately greater amount of good. 
This is untrue and absurd. 

To measure medicines correctly, some acquaintance 



692 ON MEDICINES. 

must be had with apothecaries' weights and measures. 
But as few people have at hand fine scales and 
graduated glasses, we shall, in addition to giving the 
ordinary tables, add their equivalents in such common 
measures as spoons, wineglasses, etc., which are always 
within reach, and are accurate enough for purposes of 
home treatment. They will not, indeed, suffice when 
very powerful and poisonous drugs are employed, but 
this is never called for in domestic practice. 

The measures of fluids used in pharmacy are the 
drop, the drachm, the ounce, the pint, and the gallon; 
of solids, the grain, the scruple, the drachm, the ounce, 
and the pound; see pages 552 and 553 for the tables 
of measures. 



WHAT "DOMESTIC MEDICINES" PROPERLY APE. 

As we have said, medicines are derived from all the 
kingdoms of nature, and from all the zones of the 
earth. Sea and land, earth and air, the vegetable, the 
animal, and the mineral world, alike contribute means 
to preserve the health and extend the life of man. 
But anything approaching a complete knowledge of 
all these resources can only be acquired by many 
years of arduous and exclusive labor. 

Fortunately, almost all diseases which we have to 
contend with in the ordinary history of life can be 
successfully encountered with a small number of 
remedies, and still more fortunately, or rather, and to 
speak more correctly, by a most wise and merciful 
dispensation of Providence, these few remedies are 



DOMESTIC REMEDIES. 693 

nearly always at hand, for many of the most efficient 
of them are either articles in common use for other 
purposes, and every ship, every farm-house, every 
family, is already provided with them, and only lack 
the knowledge when and how to employ them, or else 
they are well-known common domestic plants, to be 
culled from the kitchen garden, the roadside, or the 
woodland, " without money and without price." 

These are the resources which should supply the 
domestic pharmacy. Every ship captain, every farmer, 
every mother, should be acquainted with the valuable 
medical virtues which reside in these articles which 
are constantly about us, which can be procured at any 
moment, and which cost nothing. These are what 
"domestic medicines" properly are, and no education 
is complete which omits information on this impor- 
tant subject. In thousands of instances lives can be 
saved and pain relieved by knowing what medical 
properties even such every-day articles as salt, pepper, 
and vinegar possess, by learning the virtues of domes- 
tic plants, and by under standing in what cases to give 
them. 

Besides these two classes of articles, there are but 
few drugs, properly so called, which need be intro- 
duced into the home treatment of disease. Some of 
the tropical productions, and some of the mineral and 
chemical products having special powers, should be 
known. Although important in their effects, the 
latter are few in number, and can readily be mastered. 
Under these general classes, therefore, we will arrange 



694 ON MEDICINES. 

the whole number of medicinal substances which it is 
requisite to be acquainted with. 

The Medical Properties of Common Articles. 

"We shall explain in this section the healing powers 
which are resident in many articles used for the every- 
day purposes of life. When we discover how many 
such articles there are possessed of these powers, we 
are strongly impressed with the importance of learn- 
ing and remembering how to apply them, for they 
are nearly always at hand, and frequently as efficient 
as costly and rare foreign productions. 

Some of them are specifics, some of them of power 
in controlling symptoms. There is a large variety of 
diseases in which they can be advantageously used, 
and these diseases are precisely those which are of 
most common occurrence in this country. 

As elsewhere, we shall arrange the various articles 
mentioned in alphabetical order, for convenience of 
reference. 

ALCOHOL AND ALCOHOLIC LIQUORS. 

Alcohol, or spirits of wine, is of very common use in 
the domestic - arts, and there are very few families in 
which it is not present in some of its forms. It is 
obtained by distilling fermented grains, as corn, 
wheat, rye, etc., or other starchy products. All 
wines, distilled and malt liquors of every description, 
depend for their strength on the amount of alcohol 



ALCOHOLIC LIQUORS. 695 

they contain. Taken in excess, they all produce in- 
toxication, which is due to the alcohol, and is its 
peculiar effect. Proof spirit is a diluted alcohol, and 
brandy, whiskey, gin, and rum are composed of 
alcohol still further diluted (about one-half water), 
with various flavoring materials added, either arti- 
ficially or from the grains used in their manufacture. 

It has been a serious question whether alcohol in 
any of its forms should be employed in medicines, on 
account of the temptation its use offers to intoxication, 
one of the most deplorable vices which can beset a 
man. Certainly its frequent or habitual use on every 
occasion when one "feels out of sorts" is dangerous 
and to be condemned. No doubt very many drunk- 
ards have gone to their dishonored graves owing to 
the recommendations of their friends or physician to 
use a little liquor " for their stomach's sake." And 
we cannot sufficiently condemn the deplorable reck- 
lessness of some doctors in prescribing the use of 
intoxicating drinks. 

As we have previously said, the man in health needs 
no form of alcohol to maintain his powers; and he 
who is sick can nearly always find some other sub- 
stance equally efficacious, and free from the objections 
of alcohol. 

Nevertheless, as Providence has endowed this sub- 
stance with certain healing powers, a*nd as in some of 
its forms it is nearly always at hand, it is right that 
we should learn them, and avail ourselves of them in 
an emergency. 

Externally employed, alcohol and distilled spirits 



696 ON MEDICINES. 

exert two opposite effects, depending on the manner 
in which they are applied, one cooling, the other heat- 
ing. If a part of the body is well rubbed with the 
fluid, and then covered with a cloth wrung out in it, 
and the whole wrapped with a dry cloth or a piece of 
oiled silk, the skin is heated as forcibly as with a mus- 
tard plaster. Such an application is very efficacious 
wherever we want counter-irritation, as in sore throat, 
pleurisy, gout, deep-seated pains, etc. 

On the other hand, the cooling effect is obtained 
when a part is merely bathed or sponged with the 
fluid, and it is allowed to evaporate freely. Thus used, 
it is an admirable application in recent bruises or 
sprains. A " black eye" from a blow on the face can 
most successfully be avoided by constantly bathing 
the part in alcohol. So also one of the most efficacious 
means to prevent bed-sores in persons who are obliged 
to remain long confined to their beds, is to bathe 
frequently the parts exposed to pressure with strong 
alcohol. For the same reasons, pedestrians will find 
that bathing their feet morning and evening with 
strong whiskey will both prevent their blistering and 
relieve the soreness which is the common result of a 
long tramp. 

As an application to fresh wounds, wine is men- 
tioned among the earliest. Its virtues depend upon 
the alcohol it contains. Recent bums, scratches, and 
cuts are much relieved by washing with alcoholic 
liquor, and obstinate old ulcers can often be cured by 
keeping them dressed with light bandages moistened 
with the same substance. 



-7 



MEDICAL PROPERTIES OF ALCOHOL. 697 

Used internally, alcoholic liquors should be confined 
to those cases where it is necessary to tide over some 
sudden severe prostration of the powers. There is 
never any necessity for their use for a length of time, 
while there is manifest danger that if so used, they 
will become a curse. The terrible exhaustion which 
follows a gunshot wound or other severe accident 
sometimes destroys life upon the spot, unless a power- 
ful stimulus is given to counteract the shock to the 
system. Here some alcoholic drink should be given 
without hesitation, a half tumbler of whiskey or 
brandy, or a tumbler of strong wine, in such quanti- 
ties as the patient can swallow. 

So also in the poisoning from the bites of venomous 
serpents, as the rattlesnake and moccason, which abound 
in the South and West. Large doses of brandy or 
whiskey should be given at once, and continued until 
the patient shows signs of intoxication. This will 
generally prove effective, but it is a warning well 
worth remembering that this remedy will not succeed 
when the person bitten has been accustomed to the 
free use of liquor. 

"When the system is very much exhausted by low 
fevers, and little nourishment can be taken, it occa- 
sionally becomes advisable to support the patient on 
fluids containing alcohol. This is a very common 
practice, but physicians are by no means agreed as to 
how far such stimulants are necessary, and therefore 
we do not consider that they should be used unless 
they are plainly demanded to support the flagging 
powers of life. Their frequent use in colic, cholera, 



698 ON MEDICINES. 

and dysentery, is as often productive of harm as of 
good, and it is wiser to substitute some other stimu- 
lant, such as ginger or cayenne pepper tea, which is 
not likely to have injurious consequences. 

Of late years many persons have learned to drink 
largely, under the impression that they could thereby 
avoid a tendency to consumption. This dangerous 
doctrine has caused much drunkenness, and has not 
diminished the deaths from that disease; if anything, 
by inducing irregular habits, it has increased them; 
so we entirely discountenance and denounce it as of 
doubtful curative value, and likely to injure morality. 



ALUM. 

Alum is always at hand, and often the very article 
we need to effect a cure. One of its most valuable 
properties is to stop bleeding. This it does promptly, 
where no large bloodvessel has been cut. The wound 
should be thoroughly rinsed with a mixture of a heap- 
ing teaspoonful of powdered alum in a teacupful of 
water. For bleeding of the nose, take a piece of soft 
rag, wet it with the alum- water, and pass it gently up 
the nostril; or throw the water up with a syringe, 
which is better. "When there is vomiting of blood, a 
tablespoonful of the above mixture should be taken 
every half hour. In bleeding piles a salve made by 
rubbing up a teaspoonful of alum in a tablespoonful 
of lard will give great relief. 

One of our best gargles for sore throat is made from 
alum ; the receipt is : — 



MEDICAL USES OF ALUM. 699 



Take of— 

Cold sage tea, one pint. 

Alum in powder, two teaspoonsful. 

Honey (or syrup), two tablespoonsful. 
Use every hour. 



A plain solution of alum in water is nearly as bene- 
ficial. In that terrible disease of children, croup, alum 
is perhaps the most valuable medicine we have. A 
lump should be scraped or powdered very finely, and 
a teaspoonful given to the child in enough molasses 
to conceal it. Vomiting is brought on at once, and 
the child relieved. If it does not have this effect, the 
dose should be repeated. Painter's colic, or lead colic, 
is a painful kind of griping to which those who work 
in lead and lead paint are exposed. Alum in doses of 
two to four teaspoonsful a day will often relieve this 
promptly. 

A popular eye-water for sore and inflamed eyes is 
made by stirring a pinch of powdered alum into a pint 
of pure cold water. Still better is alum curd. To 
make this, take the whites of two eggs and rub them 
around with a lump of alum. They will thicken in a 
few minutes, when they are to be spread on a rag and 
laid upon the eye. The application is cooling and 
grateful. 

Alum wliey is prepared by boiling two teaspoonsful 
of alum with a pint of fresh milk, and then straining 
to separate the curd. This can be sweetened and 
nutmeg added. It is the most agreeable form in 
which to give alum to children and others. In 



700 ON MEDICINES. 

diarrhoea of long standing, with watery discharges, it 
will be found serviceable. A lump of alum the size 
of a walnut dropped in a cask of water will preserve 
it free from all impurities. A wash of a teaspoonful 
of alum in a quart of water is an excellent preventive 
of offensive sweating of the feet, armpits, etc. ; and 
may often be used with success to drive away pimples 
from the face, such as occur in young persons. 

Burnt Alum. — "When alum is exposed to moderate 
heat, it swells up and forms a light, porous, dried mass 
known as burnt alum, which is a favorite application 
to proud flesh in wounds and sores. Equal parts of 
burnt alum and white sugar are rubbed together, and 
the powder sprinkled on the flesh, which it destroys 
with almost no pain. 

BORAX. 

Every blacksmith uses borax in soldering metals, 
and it is kept on sale at every country store. Its uses 
as a medicine, therefore, ought to be generally known. 
It is principally employed externally. A solution 
made by adding a teaspoonful powdered to a tumbler- 
ful of water, is an excellent wash for scaly tetter on the 
hands or body, for pimples on the face, and to relieve 
the annoying itching of the privates with which 
persons of both sexes are sometimes troubled. A 
teaspoonful in two tablespoonsful of vinegar will often 
cure ringworm. The same amount stirred up with a 
tablespoonful of honey forms one of the best applica- 
tions to sore mouth in nursing infants and children. 



MEDICAL USES OF PETROLEUM. 701 

Equal parts of powdered borax and white sugar may 
be employed for the same purpose. 



COAL OIL. 

The natural oil, as it issues from the springs, was 
well known to the Indians, and used by them as an 
application to sprains, bruises, and sores. For this 
purpose it is not surpassed by any liniment which can 
be bought. It should be well rubbed in, and a rag 
wet with it be laid upon the swelling, if it is very 
painful. For bwrns and scalds it is equally efficacious. 
An English surgeon relates that in 1867 he was on 
board a steamer on Lake Erie when one of the en- 
gineers was severely scalded on the right wrist. As 
nothing else was at hand, petroleum was applied freely 
to the part, and the bandage wet with it. To the 
doctor's surprise, the wrist without other treatment 
healed with remarkable rapidity. 

Severe rheumatic pains in the legs, arms, and back 
are often greatly relieved by thorough and repeated 
rubbing with coal oil. A physician of forty years' 
experience, long a victim to sciatica, or neuralgic pain 
in the hip, has told us that he found more relief from 
this than any other application. 

The taste of coal oil is very unpleasant, but it can 
be given in doses of ten drops in gum-water, or in 
yelk of egg, three or four times a day, with benefit, in 
diarrhoea and dysentery. 

^Erysipelas has also been treated successfully by 
anointing the inflamed part with it. 



702 



ON MEDICINES. 



CHARCOAL. 



We have already spoken of the disinfecting quali- 
ties of charcoal, and how it should be placed in the 
sick-room to absorb the odors. It does this so com- 
pletely, that if a piece of fresh meat be covered with a 
layer of it, no smell of decay will be perceived. The 
same property renders it valuable in had health and 
foul breathing from the stomach. A teaspoonful of 
powdered fresh charcoal should be swallowed on re- 
tiring at night. 

Impure water can be purified by running it through 
a layer of coarsely powdered charcoal between two 
layers of muslin; and by placing a few lumps in a 
cask, the water will be preserved sweet. When wounds 
and sores smell foul, a charcoal poultice will remedy 
this. It is made by stirring sufficient of the powder 
into an ordinary bread and milk or flaxseed poultice 
until it is black. In diarrhoea and dysentery, when the 
discharges smell very disagreeably, a teaspoonful of 
charcoal should be given morning and evening in some 
jelly. As a preventive of cholera and contagious 
fevers, the same amount every morning before break- 
fast has been highly recommended by good authorities. 
Finally, to prevent pitting of the face in smallpox, 
probably the very best means is to smear the face 
with a thick coat of an ointment made by beating 
up a teaspoonful of powdered charcoal with a table- 
spoonful of simple cerate or clean lard. 

In all cases where charcoal is used for medical pur- 
poses, it should be either freshly made, or first heated 



MEDICAL USES OF COMMON SALT. 703 

to a red heat so as to destroy any substances it may 
have absorbed. Scorched bread is the most conve- 
nient source from which to obtain it. 



COMMON SALT. 

This familiar substance has medical properties which 
ought to be known by everybody, as it is always on 
hand and always cheap. Its effect in small doses is 
to strengthen and brace the system, to improve the 
digestion, and to prevent debility. Few people are 
aware that it is an excellent remedy in fever and ague. 
About eight to ten even spoonsful should be stirred 
into a pint of slippery-elm water, and the whole of it 
should be taken in small and regular doses between 
the attacks. 

On the sudden occurrence of bleeding of the lungs, a 
dose of a teaspoonful, taken dry, often proves success- 
ful in stopping the flow of blood. 

Strong brine, made by dissolving as much salt as 
possible in boiling water, and allowing it to cool, is 
an excellent application to bruises, sprains, and sores. 
Frosted feet will be found greatly relieved by being 
soaked in this for a quarter of an hour every evening. 
In weak conditions, the whole body may be advan- 
tageously sponged with this, or bathed with a solution 
of one pound of rock-salt in four gallons of water. 
The latter is about the strength of sea-water, which 
derives its virtues chiefly from the salt it contains. 
Persons who dislike bathing, or have no conveniences 
for it, will derive benefit by rubbing the skin of the 



704 osr MEDICINES. 

body with dry salt once a week. It is invigorating, 
and stimulates the skin very much. 

For seat worms, an injection of strong salt-water is 
a sure cure. 

For putrid sore throat, and sore throat generally, a 
famous gargle of Dr. Rush, of Philadelphia, was as 
follows : — 



Take of— 

Common salt, one tablespoonful. 

Lemon-juice, two tablespoonsful. 

Water, half a pint. 
Gargle every half hour with it. 



In cases of burns and scalds, fine salt sprinkled 
immediately over the part gives prompt relief, and 
often prevents blistering. 

CREAM OF TARTAR. 

This familiar article is medically valuable in several 
respects. It acts both on the bowels and the kidneys. 
"When persons are bilious, the bowels bound, and the 
complexion somewhat yellow, a dessertspoonful of it, 
stirred into a pint of boiling water, cooled, and taken 
twice a day on an empty stomach, will relieve the 
symptoms in a few days. In attacks of jaundice, 
where there is fever, yellowness of the eyes and skin, 
and prickling of the body, a heaping tablespoonful of 
it should be taken three times a day until the bowels 
are acted upon smartly. It is a very successful 
remedy. In dropsy, half this amount, three or four 
times a day, will diminish the swelling. 



MEDICAL USES OF GINGER. 705 

Children who have a rough skin, muddy com- 
plexion, and are generally ailing, are often improved 
by the following : — 



Take of— 

Cream of tartar, 

Flowers of sulphur, equal parts. 
Give a teaspoouful in molasses every morning. 



When children are slightly feverish from a com- 
mencing cold, they are often benefited by cream of 
tartar lemonade. To make this, pour a pint of boiling 
water on a tablespoonful of cream of tartar, add a few 
pieces of lemon-peel, and sweeten to the taste. A 
teacupful of this may be taken as desired. 

The ground cream of tartar of the stores is very 
frequently adulterated with flour, chalk, whiting, etc., 
so that when it is possible to get it in crystals it is 
better to do so. 

GINGER. 

This is the root of a plant brought from the West 
Indies. When powdered, it is a pleasant condiment, 
and when in the root, "green ginger," as it is called, 
makes an excellent preserve. Medically, its virtues 
are toward affections of the stomach and bowels, 
relieving colic, diarrhoea, and indigestion, correcting 
impure water, and stimulating the whole system. The 
forms in which it is most used are essence of ginger, 
syrup of ginger, and ginger beer. The following are 
reliable receipts for these : — 

45 



706 ON MEDICINES. 

For essence of ginger : — 



Take of— 

Sliced fresh ginger-root, four ounces, 

Alcohol, one quart, 
Let it stand for a month before using. 
Dose, 10 to 60 drops on sugar. 



For ginger syrup, boil four ounces of ginger-root 
in a quart of water four hours, adding boiling water 
to keep it to a quart. Then filter, and add enough 
white sugar to make a rich syrup by the help of heat. 
Bottle and keep in a cool cellar. 

For ginger beer, take thirteen pounds of sugar, the 
juice of twelve lemons, eight ounces of bruised gin- 
ger-root, the whites of six eggs well whipped, and 
ten gallons of water. Mix, and boil twenty minutes, 
skimming carefully. Put in a cask, and bottle after 
ten days. 

The powdered ginger of the stores is often adulter- 
ated with Indian-meal, sawdust, and other impurities. 
Therefore, for medical purposes, the bruised or green 
root should be obtained. The substance in some form 
should be in every household, as it often removes the 
temptation to use alcoholic drinks for colic, etc. A 
bowl of hot ginger tea, taken on going to bed, will 
often cure a commencing cold, and relieve irregulari- 
ties in women. 

LEMON-JUICE. 

The employment of lemonade as a refreshing and 
cooling drink in hot weather and in fevers is well 



MEDICAL USES OF LEMOX-JUICE. 707 

known. It is best when made of a fresh, sound lemon. 
But when it is not convenient to carry these, lemon 
syrup may be substituted; not, however, that lemon 
syrup which is found in the stores, which is an 
unwholesome mixture of tartaric acid flavored with 
oil of lemons, but made at home after the following 
receipt : — 



Take of— 

Strained lemon-juice, one pint. 

White sugar, two pounds. 
Mix them, and simmer for half an hour. 



It should be bottled with sound corks, and if there 
is any difficulty in keeping it, add a tablespoonful of 
brandy to each bottle. 

In scurvy there is no better remedy than a table- 
spoonful of lemon-juice three or four times a day. 
During the war there was a great deal of scurvy in 
the army of the Southwest, and it is not uncommon to 
see its symptoms in scrofulous, ill-fed persons (see 
Scurvy). Some very hopeless cases of dropsy have 
been cured by eating lemons, the skin being removed, 
and the substance cut into small pieces and mingled 
with sugar. The patient commences on one daily, and 
gradually increases to ten or fifteen, meanwhile eating 
principally animal food. Obstinate heartburn (acidity 
of the stomach) is sometimes relieved very rapidly by 
simply sucking the juice of a lemon. Very strong 
lemonade can be used with advantage in influenza and 
cold in the head. The juice removes ink-stains and 
freckles from the skin. But one of the most valuable 



708 ON MEDICINES. 

of its uses is in inflammatory rheumatism. A wine- 
glassful of the juice, sweetened, given five or six times 
a day, will often work surprising cures in this painful 
and lingering disease. 

LIME. 

There are very few places where quicklime cannot 
be obtained; and there are a great many complaints 
in which it renders very important services. It is 
generally made by burning limestone in a kiln, but it 
can also be prepared from oyster and other shells. 
Pure or quicklime is irritating and caustic. When 
it is blown into the eyes in a condition of fine powder, 
as not unfrequently happens to those obliged to work 
in it, it causes violent inflammation. The proper 
treatment is to pour immediately a small quantity of 
sweet oil between the Jids. The lime joins with the 
oil and forms a bland liniment, very soothing to the 
inflamed surface. 

One of the most valuable uses of lime is in those 
very common and distressing children's complaints, 
croup and diphtheria. These diseases often attack 
suddenly and violently, and every parent should be 
ready to render immediate relief without waiting to 
send for the doctor. This can readily be done by 
simply having the child hreathe the vapor from slaking 
lime. The directions to be observed in doing this are 
as follows : take a piece of unslaked lime the size of 
an orange and put it in a pitcher or a bowl ; r throw a 
cloth over the head of the child, large enough to cover 
both the head, face, and the bowl; then pour a little 



MEDICAL. USES OF LIME. 709 

hot water on the lime, and, placing the vessel under- 
neath the cloth, tell the child to breathe freely. It 
gives very prompt relief, but to effect a permanent 
cure it must be continued, a fresh lump being slaked 
every half hour, until the difficulty of breathing has 
disappeared. The very worst cases of croup and 
diphtheria will generally yield almost at once to this 
simple means, which is always at hand even in remote 
settlements. 

The eminent French physician, Dr. Trousseau, found 
great advantage in cases of inflammatory rheumatism 
from the use of a "syrup of lime." His prescription 
has also been used in this country by several intelli- 
gent physicians with good success. The syrup of 
lime is prepared as follows: — 



Take of— 

Quicklime, one tablespoonful. 

White sugar, four tablespoonsful. 

Boiling water, one quart. 
Mix well, and strain when cool. 
Dose, one teaspoonful every three hours. 



" Lime-water" is one of the most useful articles in 
domestic medicine. It should be freshly prepared, as 
after being kept some time it loses its powers. Its 
preparation is simple. Take about a half pound of 
fresh unslaked lime, and pour upon it a gallon of hot 
water. Set aside the mixture for a few hours, and 
then pour off the clear liquor, being careful not to 
stir it. 

It has various uses. As a gargle in croup and 
diphtheria, it is one of the best. Mixed with an equal 



710 ON MEDICINES. 

quantity of olive or linseed oil, it makes a thick oily 
mixture, called carron oil, which is an excellent appli- 
cation in burns and scalds. The lime-water alone is a 
soothing application to those itching eruptions called 
hives, and can be taken internally with great advan- 
tage in the same affection. Its dose is a tablespoon- 
ful, and it is best taken in milk, which conceals the 
taste. 

Where there is that burning sensation in the stomach 
called heartburn (which is a form of dyspepsia), a 
dose of lime-water will give prompt relief. Indeed, 
it is useful in many forms of dyspepsia where this 
sensation is not present, and also in slight summer 
diarrhoeas. 

Its chief employment is in the bowel complaints of 
children. Where the child has much wind, a restless 
sleep, slight diarrhoea, and is fretful, very frequently 
the difficulty is that its stomach is sour. This condi- 
tion is promptly relieved by the lime-water. It should 
be mingled with the child's milk in the proportion of 
one-quarter of lime-water to three-quarters milk, and 
given constantly. 

MUSTARD. 

This condiment, which is so universally used at 
meals, is hardly less popular as an article of household 
medicine. Every one is familiar with the mustard 
plaster as an application for pain. We have pre- 
viously explained how it ought to be made (page 522). 

For internal use, mustard is also valuable. It is the 
very best article with which to bring on immediate 



MEDICAL USES OF SWEET OIL. 711 

vomiting when some suspected poisonous substance 
has been swallowed. For this purpose, take a large 
teaspoonful of ground mustard, mix it in a tumbler of 
warm water, and swallow it rapidly. 

A tablespoonful of white mustard seeds (whole) 
mingled with molasses, and swallowed once a day, act 
gently on the bowels, and are beneficial in dyspepsia 
and constipation. Mustard wheys, made by boiling a 
dessertspoonful of ground mustard in a pint of milk 
and straining, can be usefully employed in dropsy in 
the dose of a wineglassful three times a day. 



OLIVE OIL. 

This is also familiarly known as sweet oil, table 
oil, and salad oil. It is obtained by pressure from 
olives. The oil is nutritious, and, when not rancid, is 
pleasant to the taste. In cases of poisoning by cor- 
roding poisons, it should be given in doses of a wine- 
glassful every few minutes. Cramp colic will often 
yield promptly to a dose of the same size. The oil 
acts gently on the bowels, and is, therefore, useful in 
constipation. A teaspoonful of it rubbed along the 
spine of a very young infant is a far better means to 
loosen its bowels than anything given by the mouth. 
Several cases of snake-bites have been reported as 
benefited by giving a wineglassful of this oil every half 
hour, and constantly rubbing the bitten parts with it. 

Many skin diseases are greatly benefited by anoint- 
ing daily with sweet oil, and the natives of the east 
believe that it prevents them from taking contagious 



712 ON MEDICINES. 

diseases. Infants, when their skin is hot and dry, are 
often greatly relieved by having it gently and tho- 
roughly rubbed over their bodies. 

"When a person is prostrated by attacks of gout and 
rheumatism, and suffers from general debility, the use 
of this oil, a teaspoonful three times a day, the quan- 
tity gradually increased until it begins to loosen the 
bowels, will produce an excellent result. 

RED PEPPER. 

This is also known as cayenne pepper, or capsicum. 
Its pungent, stimulating properties render it of much 
value as a medicine. In indigestions and dyspepsias, 
when eaten freely with the meals, it relieves the pain 
and sense of weight, and promotes digestion. Of late 
years it has been praised as one of the best remedies 
in delirium tremens, the sleeplessness and madness 
brought on by hard drinking. A teaspoonful of it 
should be mixed with molasses and swallowed at once. 
The same dose is also a very efficient remedy when 
seasickness is coming on, and much to be recom- 
mended above the brandy, etc., usually prescribed. 

Red pepper tea is an excellent gargle in sore throat, 
especially in the following combination, which we can 
recommend: — 



Take of- 






Red 


pepper, one teaspoonful. 




Salt, 


one teaspoonful. 




Water and vinegar, of each half 


a pint. 


Boil for a few minutes, then strain and cool. 



MEDICAL USES OF NITRE. 713 

A mouthful of this can be gargled every hour. 

As a liniment, strong red pepper tea, or the receipt 
just given, is useful in rheumatic pains, stiff joints, 
neuralgia, etc. Sometimes a plaster of it, with Indian- 
meal, is very effective. 



SALTPETRE, OR NITRE. 

This substance is also called nitrate of potash, and 
is well known as one of the substances of which gun- 
powder is composed, and is also much employed in 
domestic life. 

As an internal medicine it has a cooling* power in 
feverish conditions. A teaspoonful of it (powdered) 
should be stirred in a pint of cold water, and two 
tablespoon sful of this swallowed every hour or two. 
It acts on the kidneys and the skin. A heaping 
dessertspoonful of it, boiled for a few minutes in a 
quart of new milk, makes a useful medicine in gravel; 
a tablespoonful of it is to be taken about every hour 
through the day. In inflammatory rheumatism it has 
an excellent effect, and may be taken in the same 
doses, but dissolved in a quart of water instead of 
milk, and the whole taken in small doses, frequently 
repeated, within twenty-four hours. 

A teaspoonful of saltpetre in a tumbler of water 
makes an excellent gargle in sore throat It should be 
used every hour. In attacks of asthma speedy relief 
is often found by breathing the smoke of burning 
paper which has previously been soaked in a strong 
solution of saltpetre, and then dried. In cases of 



714 ON MEDICINES. 

dysentery it sometimes acts very beneficially; a tea- 
spoonful of it is to be stirred in a tumbler of water, 
and a tablespoonful of this given every hour. 



SODA, BICAKBONATE OF SODA, BAKING SODA. 

This product is obtained from common salt by sub- 
mitting it to a series of chemical processes unneces- 
sary to detail. It is sold at all grocery stores for 
kitchen use in making "soda biscuits," bread, cleaning, 
etc., and there are few families who do not keep it on 
hand. Chemically, it is an "alkali," and one of the 
best for internal administration. 

Hence its uses as a medicine deserve to be known 
to every one, as they are quite efficient. One of the 
most valuable is in that form of dyspepsia where 
there is sourness of the stomach, heartburn, or water- 
brash. "With this symptom are usually associated a 
coated or very red tongue, a capricious appetite, a dry 
mouth, a sense of fulness over the stomach, pain after 
eating, and a general disagreeable feeling, and low 
spirits. This condition finds relief in the use of soda, 
and especially in a full dose taken immediately after 
meals. A teaspoon even full should be stirred in a 
wineglass of water and swallowed at a dose. 

Children who are wakeful, restless, and cross, who 
scream easily, and vomit curdled and sour milk, who 
have movements which are thin, greenish, and sour, 
suffer from this form of dyspepsia. If they are fed on 
milk, ten grains of soda should be put in each quart 
of their food; if at the breast, a pinch of soda and 



MEDICAL USES OF SODA. 715 

five or six drops of essence of peppermint should be 
stirred in a tablespoonful of water, of which a half 
teaspoonful should be given after nursing. 

Gravel and stone in the bladder are painful and ter- 
rible complaints, which can be treated by nothing so 
efficacious as soda. By using daily two or three tea- 
spoonsful dissolved in the drink, the tendency to the 
formation of these stones is done away with. Soap- 
makers' lye, which is occasionally recommended for the 
same purpose, acts virtually the same as soda, though 
it is a less agreeable remedy. 

The daily use of soda should not be carried too far, 
as it is said by some to weaken the stomach, thin the 
blood, and finally to lead to a condition closely resem- 
bling scurvy. 

Inflammatory rheumatism can be treated with fre- 
quent success by bicarbonate of soda. Certain mineral 
springs, as we have already mentioned in our article 
on them, contain this ingredient in large quantities, 
and are precious, if not almost specific, remedies 
in chronic rheumatism and gout. They include the 
famous Vichy waters of France, and those which we 
have called "alkaline" springs. 

Baths containing soda, whether of artificial or 
natural water, are extensively used in diseases of the 
sJcin, especially those of a dry, scaly character. The 
water should be about the temperature of 80°, and, 
when made artificially, a handful of that form of soda 
employed in washing (familiarly called "washing 
soda") should be stirred into the bath. 

"Soda-water," as sold in the shops, contains no 



716 ON MEDICINES. 

soda; but formerly it was made by dissolving forty 
grains of soda in a pint of the water, and impreg- 
nating it with carbonic acid gas. In this form it is a 
pleasant method of taking the medicine. 

The dose of soda is from ten to thirty grains ; but 
as much as an ounce daily may be taken with benefit 
in some cases. It should always be dissolved in an 
abundance of water, as otherwise it is disagreeable. 
Soda lozenges are kept by druggists for those who 
suffer from sour stomach. 



SULPHUR. 

This simple and abundant article is only neglected 
in medicine because it is cheap. Old Dr. Physick, of 
Philadelphia, used to say that it would be often pre- 
scribed if it cost a dollar a pound instead of a few 
cents ! Old cases of rheumatism are often very much 
improved by sulphur baths and sulphur tea. The 
latter is made by breaking up a pound of roll sulphur 
and simmering it for half an hour. A wineglassful 
should be taken hot five or six times a day. The best 
sulphur baths are those which Nature provides in hot 
sulphur springs, but artificial ones can be prepared 
by stirring a handful of sulphur into a tub of warm 
water, or, what is better, by using the sulphur vapor- 
bath. The patient is stripped and seated on a cane- 
bottomed chair, with a thick blanket fastened below 
his chin and enveloping both his body and the chair. 
A hot brick is then placed on a dish beneath the chair, 
and sprinkled with flowers of sulphur. This vapor- 



MEDICAL USES OF SULPHUR. 717 

bath should last from a quarter to half an hour, and 
is an admirable remedy in old rheumatic cases and 
itch. Sulphur in this last-mentioned troublesome and 
disgusting complaint is the best remedy in the world. 
It may be applied either as a vapor-bath or in the 
following ointment : — 



Take of— 

Flowers of sulphur, one tablespoonful. 

Clean lard, three tablespoonsful. 
Eub well together. 



The skin is first to be thoroughly washed with 
warm water and soft soap, and then rubbed morning 
and evening with this ointment. It is a sure cure. 

Sulphur loosens the bowels, and one or two tea- 
spoonsful of the flowers mingled with molasses is an 
effective dose for this purpose. 



TAR. 

There are few articles in the shop of the apothecary 
with more healing virtues than that common sub- 
stance, tar. It can be used either externally, by the 
stomach, or in a state of vapor. 

The value of tar on old sores, galls, cuts, and 
bruises is known to every farrier. It prevents flies 
and maggots from troubling the wound, and aids in 
healing. In skin diseases, tar ointment is an excellent 
compound. It is made by melting suet or clean lard, 
and adding to it at a moderate heat an equal amount 



718 ON MEDICINES. 

of tar. For scald-head, scurf, and old sores it has a 
deserved reputation. 

Internally, tar is most conveniently used as tar- 
water. This is made by pouring half a gallon of 
boiling water on half a pint of tar. Bishop Berkeley, 
who lived in the last century, was cured of a trouble- 
some dyspepsia by this, and believed it such an ex- 
cellent medicine that he wrote a book in its praise. 
From one to two pints may be taken every day. It 
is advantageously used in coughs and colds, dyspepsia, 
slow diarrhoeas, and general weakness. 

Tar-vapor has been found of great use in coughs, 
and has even been said to have cured consumption. 
It can conveniently be made by placing over a 
common nurse-lamp a dish of water, and in this a cup 
containing tar. In a few minutes the air of the room 
will be filled with the vapor. 



TURPENTINE. 

Spirits of turpentine, or oil of turpentine, is obtained 
from fir and pine trees, and is extensively used in 
domestic arts. Its medical properties are also nume- 
rous. 

Externally, it forms a part of some of the most 
effective liniments which we have. It reddens and 
irritates the skin of some persons quite violently, and 
it is best, therefore, to mix it with equal parts of olive 
oil. For sore throat, pain in the back, rheumatism, 
stiffness, and neuralgic points, we recommend the parts 
to be thoroughly rubbed with it morning and evening. 



MEDICAL USES OP TURPENTINE. 719 

Taken internally, turpentine is one of the best 
means to destroy and expel worms in the bowels with 
which we are acquainted. Even tapeworms cannot 
withstand its action. A teaspoonful of it may be 
given at night, rubbed up with the yelk of an egg and 
sugar, and followed the next morning by a dose of 
salts or castor oil. In long-continued looseness of the 
bowels or diarrhoea, twenty drops on sugar three times 
a day will often effect a cure. Old cases of rheuma- 
tism are improved not only by having it rubbed on the 
affected parts, but by taking ten to twenty drops 
several times a day. It proves also very beneficial in 
spitting of blood, when it should be given in ten-drop 
doses every ten minutes. When the system is worn 
out with low fevers or dysentery, and the tongue looks 
dry, red, and cracked, five drops mixed with a little 
yelk of egg, sugar, and w^ater, given every two hours, 
is an approved remedy. 

Sometimes turpentine given internally causes pain 
and burning in passing water. "When this is the case, 
it should be stopped, and the patient placed for some 
time in a warm sitz-bath. 



VINEGAR. 

Strong cider vinegar has long been known to pos- 
sess valuable medicinal virtues. Mixed with water, 
and sweetened with molasses, it forms a popular tem- 
perance beverage in harvest, as we have before men- 
tioned (page 103). 

For dysentery, vinegar saturated with common salt 



720 ON MEDICINES. 

has a deserved reputation. A large tablespoonful of 
the mixture is to be added to four of hot water, and a 
tablespoonful of this is to be swallowed as hot as may 
be every few minutes until the whole is taken. In 
poisoning from washing-soda or potash, vinegar mixed 
with water should be drunk. In some cases of inflam- 
matory rheumatism, when the patient is worn out or 
has a feeble constitution, a teaspoonful of strong 
vinegar taken twice a day has been found of great 
value. 

For a gargle, and as a wash to strains, bruises, and 
old sores, salt and vinegar is an excellent mixture. In 
feverish conditions, and in the night-sweats of con- 
sumption, the whole body may be advantageously 
sponged with vinegar and water. "When, as occa- 
sionally happens, small particles of lime get in the 
eye, causing severe pain and danger of inflammation, 
the proper remedy is to wash the eye carefully with 
weak vinegar and water. 

The smell of burning vinegar was long supposed to 
prevent the contagion of fevers, but it cannot be 
depended upon. Very hot vinegar applied on a flan- 
nel early to a felon, boil, or swelling of the breast, will 
sometimes "backen" it. 

Vinegar bought in the stores is often a poor stuff 
manufactured from oil of vitriol (sulphuric acid), 
whiskey, or high wines, not fit to use. It should be 
made from pure cider or wine. 

It has sometimes been recommended to prevent persons be- 
coming too fat; but this use is dangerous and unnecessary. 
Several instances have come to our knowledge where ladies 



MEDICAL USES OF WATER. 721 

have ruined their health hy this folly, and one in which con- 
sumption was brought on. 



WATER. 

In the article on Baths many of the effects and uses 
of water, hot, cold, and medicated, have been con- 
sidered. But there are other important uses in medi- 
cine to which it is applied that deserve separate 
notice. 

Sponging the body in fevers with cold water, or 
water mixed with vinegar, is a proceeding that should 
not be neglected. The whole body should be sponged 
about twice a day. It is extremely refreshing to the 
patient, and may be used with perfect safety in fevers 
of all kinds. The temperature of the water should be 
that most agreeable to the patient. 

As a drink in fevers, the old custom was to prohibit 
water; but a wiser plan is to allow as much of it as 
the patient wishes. 

In sunstroke, fainting, stupefaction from opium, etc., 
the first and best thing to be done is to dash cold 
water over the head, neck, and chest, after removing 
the clothing. It may also be poured from a bucket 
held about six feet above the head. This will re- 
establish the sensation more rapidly than any other 
treatment. 

Cold water to the head is always called for where 
there is much pain, flushing of the cheeks, a hot, dry 
skin, a bright, glittering eye, and a wildness of expres- 
sion or language. 

46 



722 ON MEDICINES. 

A draft of cold water is an efficient expedient for 
calming the violent action of a palpitating heart. 

In bleeding, whether from a cnt surface, the nose, 
lungs, or womb, cold water is of great value. 

For an external application to bruises, cuts, injuries, 
and wounds of all descriptions, it is not surpassed by 
any medicinal substance. The part should be covered 
by a layer of tow, cotton, lint, or old muslin, kept 
constantly wet with cold water. This prevents in- 
flammation, and hastens cure. 

Hot water is also a valuable agent. Internally it 
should generally be used at about 100° Fahr. It 
causes in large quantities nausea and sometimes 
vomiting, but is valuable by diluting the blood. In 
dyspepsia attended with a sensation of coldness at the 
stomach and cold hands and feet, a cupful of water 
taken as hot as it can be drunk affords very con- 
siderable relief. 

Clothes wrung out in hot water and applied to the 
throat and chest often give much relief in croup, sore 
throat, and asthma. A warm hip-bath will frequently 
relieve the distressing sensations of dysentery, the 
itching of piles, the pain attendant on difficulty of 
passing water, and the irritations which sometimes 
arise about the genital regions. 

The vapor of hot water, or, in other words, steam, 
when inhaled, is often efficient in relieving coughs, 
colds, sore throats, and the difficulty of breathing in 
asthma and croup. 



common substances largely medicinal. 723 

The Medical Virtues of Domestic Plants. 

There is a pleasant belief among many, that a wise 
Providence has placed within the convenient reach of 
all — in the common substances which the daily needs 
of our bodies in health gather around us, and in the 
plants which bud and blossom before our eyes, and 
which our heedless feet trample in the dust without a 
thought — the remedies and specific cures for all the 
diseases which afflict us. As a stimulant to our 
minds, and as a reminder that man's highest duty is 
to labor, these beneficent properties lie concealed 
until painstaking study and observation reveal them 
to us. 

Whether we can attach full faith to this attractive 
theory, or whether, as most physicians say, we must 
recognize it true only to a very limited extent, certain 
it is that in our woods and fields grow many a plant 
and tree endowed with properties which assuage pain, 
shorten sickness, and hasten the return of health. 
Perhaps there is hardly a plant but has some such 
power to some at least slight extent. Vast numbers 
of them have been tried and recommended for one 
disease or another, or for the relief of this or that 
symptom. Many works on popular medicine make a 
display of a long list of such plants, and, in order to 
fill up their pages, introduce many which are scarce, 
or which have no decided merit, or which have never 
fairly been tested. 

This is not our plan. We propose to mention 
comparatively but few, and those shall be common 



724 ON MEDICINES. 

over wide districts of country, and of well-recognized 
remedial powers. They shall be such as are % readily 
recognized by most persons who live in the country, 
and require no special botanical knowledge to dis- 
tinguish. 



WHEN" AND HOW TO GATHER MEDICINAL PLANTS. 

Before proceeding to explain the uses of domestic 
plants in medicine, we must give instructions how to 
gather and preserve them. Everything depends on 
doing this properly. Unless the plant is gathered at 
the right season, and preserved with care, it loses 
many if not all its medicinal powers. 

The following instructions are those which the 
largest dealers recommend to the professional gath- 
erers, and may be depended upon- for general accuracy. 

Most medicinal roots are perennial (that is, the 
roots continue more than two years, whether the 
leaves continue or not), and should be gathered any 
time between maturity or decay of the leaves or 
flowers, in the summer or fall, and the vegetating of 
the succeeding spring. Biennial roots, or those that 
live but two years (like burdock and yellow dock), 
should be collected of the growth of one year — any 
time between September and the time they commence 
running up to seed in the following spring. 

Barks should be gathered as soon after they will 
peel in the spring as possible, and all the moss care- 
fully removed. It is usually best to fell the tree, and 
remove the moss while the bark is on the tree. 



--vgjSP^' 




*Vl /t 




.■■• i 



HOW TO GATHER MEDICINAL PLANTS. 725 

Leaves and herbs should be collected just before 
they mature, and before they begin to fade; the stems 
and stalks rejected, as when dry they are a hard woody 
substance, nearly inert. 

Flowers when they first open; and 

Seeds just before they are quite ripe, as they, like 
leaves and flowers, ripen after being gathered. 

Hoots should be thoroughly cleansed from dirt and 
foreign substances, and if large, like Indian turnip, 
etc., sliced. 

All the above articles should be dried; the sooner 
the better. For the first few days it is best to expose 
them to the sun and air, avoiding any dew or damp- 
ness; then spread around on floor and shelves, watch- 
ing them to see that they do not heat by being piled 
too thick, till nearly dry. Most roots require from 
three to six weeks to dry sufficiently to be safe. 

For shipping, it is best to pack them hard in coffee- 
sacks or large gunnies and burlaps ; the next best are 
good flour-barrels. 

As we are writing for many who have no knowledge 
of the scientific classifications of the vegetable king- 
dom as adopted by botanists, we will divide the prin- 
cipal domestic plants used as drugs into two very 
simple and obvious classes, (1) the trees and shrubs, 
and (2) the herbs and roots. As a rule, the stalks 
and leaves of the latter class die and fall during the 
winter season, while the trunks of the former remain 
and increase from year to year. 



726 ON MEDICINES. 

1. DOMESTIC TREES AND SHRUBS. 

These are usually of many years' growth; some 
evergreens, others shedding their leaves in winter. 

THE AMERICAN POPLAR. 

This handsome tree is known also as the "tulip- 
tree," and by botanists the Liriodendron tulipifera. It 
is well known in most parts of our country as a con- 
spicuous species in our forests. The inner bark has 
been long used as a tonic and as a curative means in 
fever and ague. It is best taken in a powdered form, 
a heaping teaspoonful being an average dose, which 
may be repeated several times a day. A strong de- 
coction, prepared by boiling the fresh bark in water, 
may be substituted for the powder. In both these 
forms it has been used with advantage in the com- 
plaints above mentioned, and also in chronic rheuma- 
tism, dyspepsia, and general debility. 

BEAR-BERRY. 

This is an evergreen shrub known to botanists as 
the Uva ursi. It grows in the more northern States 
of our Union in abundance. The leaves are the only 
part used in medicine. They should be collected in 
the autumn. A strong tea made from them is of 
marked value in diseases of the kidneys and bladder, 
where there is a deficiency or difficulty in the passage 
of water. Gravel, inflammation of the bladder, and 




Castor Oil (p. 751). 




To face p. 727. 



Elder (p. 727). 



MEDICAL USES OF DOMESTIC PLANTS. 



727 



difficulty in retaining the water, are improved by its 
use. The dose is a wineglassful of the decoction 
three or four times a day. 



BLACK ELDER. 

The elder-bush is commonly found in low, moist 
grounds and along fences. The larger variety seen in 
cultivated grounds has been introduced from Eng- 
land, but the properties of both are alike. The parts 
used medicinally are the flowers, the berries, and the 
inner or second bark of the branches and roots. 

The ointment made by stirring the fresh flowers or 
the inner bark into clean melted lard and subsequently 
straining, enjoys a high reputation for efficacy in 
slight hums, scalds, and wounds, and in dressing old 
and obstinate sores. The late Stephen Girard, of 
Philadelphia, was so partial to this ointment that he 
used to prepare it with his own hands and keep it in 
the house for distribution to his friends. 

The berries are somewhat laxative, and also act on 
the skin. They can be employed in rheumatism, 
gout, skin diseases, and habitual constipation with 
advantage, and also in scrofula. Their juice can best 
be preserved by mixing it with sugar, a pound to the 
pint, then boil and bottle, adding to each pint a 
wineglassful of strong brandy. The bottles should be 
well corked and kept in a cool place. The dose is 
from a dessertspoonful to a tablespoonful three times 
a day. This is of especial value in scrofula. 

The juice of the fresh root, or a strong decoction of 



728 ON MEDICINES. 

it, in wineglassful doses, acts smartly on the bowels, 
and is used in dropsy with advantage. Sometimes it 
causes vomiting, and in that case should be suspended 
for a day or two. 

BLACKBERRY. 

The root of the blackberry and dewberry has a very 
salutary effect on many diseases of the bowels, as di- 
arrhoea, dysentery, and the summer complaint of chil- 
dren. A decoction from the root is not unpleasant to 
the taste, and is agreeable to the stomach. It should 
be prepared by boiling a heaping tablespoonful of the 
smaller roots, or the bark of the larger, in a pint and 
a half of water down to a pint. Of this one to two 
tablespoonsful may be given to an adult three or four 
times a day. 

The domestic preparations known as "blackberry 
syrup," " blackberry cordial," and " blackberry wine" 
are all possessed of similar medical properties, though 
in a less degree. 

BURDOCK. 

The portion of this plant which is used medicinally 
is its root. A strong decoction, made by adding a 
handful of the freshly bruised root to three pints of 
water, and boiling to two pints, has a decided action 
on the skin and moderately so upon the bowels. The 
dose is a pint a day. In scrofulous conditions of the 
system, and in obstinate skin diseases, this will some- 
times bring about a cure when all other means fail. 




To face p. 728 



MEDICAL USES OF DOMESTIC PLANTS. 729 

The juice of the mature leaf may also be given, in 
doses of a teaspoonful three times a day. 

CLEAVERS, OK GOOSE-GRASS, 

Called by botanists Gallium aperine, is a common 
annual plant in the United States. It acts decidedly 
upon the skin and kidneys, and has been found of- 
value in obstinate diseases of the slcin, and also where 
there is suppression of urine, and in gravel. It may 
be given in the form of decoctions, made by boiling a 
handful of the recent herb in a quart of water for 
twenty minutes, of which a tumblerful is to be taken 
three times a day. 

DOGWOOD. 

This familiar tree grows in all our forests from 
Maine to the Gulf of Mexico. The part which is 
used in medicine is the bark, especially that of the 
root. Taken in a strong tea or decoction, made by 
boiling a handful of the bark in a quart of water, 
cooling and straining, it will often break an attack of 
fever and ague. When the system is feeble, and the 
appetite poor, this preparation taken in wineglassful 
doses three times a day will give strength and appe- 
tite. 

JUNIPER. 

The juniper is probably a native of this country, as 
we find it growing wild in many districts. Its berries 
have long been famous for their power of acting upon 



730 ON MEDICINES. 

the kidneys and increasing the discharge of liquids 
from the system. They are chiefly used in dropsy, in 
slcin diseases, and the early stages of scrofula. They 
may be given directly, rubbed up with sugar, in doses 
of one or two teaspoonsful three or four times a day. 
But it is more convenient to take a tablespoonful of 
them, and, having thoroughly bruised them with a 
hammer (taking care to break their seeds, as in them 
the oil is retained), pour upon them a pint of "boiling 
water. When cool, the whole may be drunk in the 
course of twenty-four hours. Care should be taken 
that the berries used are fresh, sound, plump, and 
black, as when they become old they are generally 
worthless. 

OAK-BARK. 

The white and the black oak are the two species of 
oak most abundant in the forests of the United States. 
The bark of both is used in medicine, and there is not 
much difference in their effects. That of the white 
oak should be preferred, however, when it is admin- 
istered internally, as it is milder and less acrid than 
the bark of the black oak. 

The bark may be given with -advantage in fever and 
ague, obstinate chronic diarrhoea, and in bleeding from 
the lungs. The acorns, when roasted and prepared like 
coffee, are believed to be a remedy in scrofula, when 
this disease is in its early stages. This u acorn coffee" 
should be taken with cream and sugar at each meal. 

The more frequent use of oak-bark -is as an external 
application. The decoction can be used with benefit 




'/Virginia Snakeroot 

To face page 730 



MEDICAL USES OF DOMESTIC PLANTS. 731 

as a bath, particularly for children, who cannot take 
medicines, in cases of weakness, looseness of the 
bowels, scrofula, and fever and ague. Used as a 
gargle, it is often serviceable in sore throat, and when 
there is a distressing tickling in the throat, inciting to 
a cough; it has also been recommended as a wash in 
old sores and foul ulcers; or a poultice made from the 
powdered bark will be of equal benefit. 

THE PERSIMMON. 

The persimmon is familiar to all residents in the 
more southern States, on account of its highly prized 
fruit. Its medical properties also are quite well known. 
They reside in the fruit and in the bark. The former 
differs very much in taste when ripe and unripe. The 
puckering, astringent property of the half-ripe fruit 
has been found to be advantageous in dysentery and 
diarrhoea of long standing. When ripe, the fruit is 
pleasant to the taste, and is believed by some to have 
the power of expelling worms from the bowels. If 
this is so, it should be freely allowed children. 

The bark is very bitter to the taste, and, used in the 
form of a strong tea, has been employed with success 
in the treatment of fever and ague and as a gargle in 
sore throats of a severe character. 



poke- weed. 

This plant, whose botanical name is Phytolacca 
decandra, is also known as poke-root, red weed, and 



732 ON MEDICINES. 

pigeon-berry. All parts of it are medicinal ; but the 
root and the berries are the portions generally em- 
ployed. The juice pressed out of the full-grown 
leaves and slowly dried in the sun furnishes an excel- 
lent application for ordinary scaly tetter, such as often 
affects the joints of the fingers. It should be applied 
every night and morning. 

A strong decoction of the root is a valuable remedy 
for many diseases of the shin, especially where there is 
much troublesome itching; The juice of the berries, 
and the dried berries themselves, have long been em- 
ployed in the treatment of rheumatism, particularly in 
cases of long standing. A tablespoonful of the juice 
is an ordinary dose, or from ten to twenty dried ber- 
ries, five or six times a day. The decoction of the 
roots has also been found advantageous in piles; and 
an ointment prepared by mixing the powdered root or 
leaves with lard, and simmering ten minutes, has been 
found efficacious in scalled head and other troublesome 
skin diseases. Some have even claimed that the juice 
of the leaf can occasionally cure a cancer, but this we 
hold very doubtful. 



SASSAFRAS. 

This aromatic tree, found in all parts of our 
country, had formerly a much higher reputation in 
medicine than is now conceded to it. The parts used 
are the bark of the root, and the pith of the extremi- 
ties of the branches. The latter is found in slender 
round pieces, very light and spongy. When placed in 



MEDICAL USES OF DOMESTIC PLANTS. 733 

water, it forms a ropy, clear liquid, which possesses 
very soothing and agreeable qualities. It is an agree- 
able and useful drink in dysentery and inflammation 
of the bladder, and, locally applied, gives great relief 
in inflammation of the eyes. 

The bark, made into an infusion by the addition of 
cold water, forms a pleasantly flavored drink, and has 
been found of value in diseases of the skin and linger- 
ing cases of chronic rheumatism. 



WHITE WALNUT. 

This tree, called by botanists Juglans cinerea, is 
known in different parts of the country as the butter- 
nut, oilnut, or white walnut. The portion which i,s 
medicinal is the inner bark of the root. This furnishes 
one of the best mild purgatives which can be found. 
It was extensively used by the surgeons during the 
American Revolution, and has been popular with phy- 
sicians ever since. It is especially valuable where 
there is habitual constipation of the bowels, or in 
dysentery and biliousness. 

The best time for collecting the bark is in June. 
.It may be made into a tea, an ounce to the quart, a 
wineglassful of which is a dose. A more elegant 
form, especially for giving to children, is a cordial, 
which can be made as follows : The bark is to be 
well broken and beaten, so as to make a soft, stringy 
mass, which is to be placed in an earthen vessel, 
closely packed down. Boiling water is then poured 
in, sufficient to cover the whole, and the vessel is to be 



734 ON MEDICINES. 

closely covered and placed on live coals for about two 
hours. The whole is then to be strained, and sugar 
enough added to the clear liquid to make a syrup. 
This is to be bottled, a little brandy or whiskey to be 
added to each bottle in order to preserve it. The dose 
for a child a year old is a tablespoonful, repeated till 
it acts smartly on the bowels. 



WILD CHEERY. 

This tree abounds in most parts of the United 
States. Its flowers are white, with an odor of bitter 
almonds, and the fruit is black, with a pleasant taste. 
Its name in pharmacy is JPrunus virginiana. The 
parts used in medicine are the berries and the inner 
bark of the roots and branches. The former are pre- 
served in brandy or whiskey, which extracts their 
virtues; the latter is dried, and taken in the form of 
an infusion, made by pouring a quart of cold water on 
a heaping tablespoonful of the bark broken into small 
pieces, and allowed to soak twenty-four hours. A 
wineglassful of this four times a day is an average 
dose. The shops also keep a "syrup of wild cherry 
bark," of which a teaspoonful may be taken. 

The uses of wild cherry are especially marked in 
cases of general weakness, where there is poor diges- 
tion, lack of appetite, nervousness, and cough. In the 
early stages of consumption, and in the recovery from 
sudden and exhausting diseases, it is of marked benefit. 
Coughs and colds of long standing are often rapidly 
improved. Palpitation of the heart, and general 



MEDICAL USES OF DOMESTIC HERBS. 735 

debility connected with disturbance of the heart, have 
frequently been relieved by its use. 

willow. 

The inner bark of the willow-tree has had an exten- 
sive reputation as a remedy in fever and ague and 
similar complaints which arise from exposure to 
swamp-poisoning. The form in which it is usually 
taken is that of a strong decoction. During the last 
war, experiments with it were conducted on a large 
scale in the armies both North and South. It was 
found to exert a decided power, but by no means 
equal to quinine. 

2. DOMESTIC HERBS AND PLANTS. 

The majority of these have a soft stalk, which dies 
down in the winters of the north temperate zone, the 
plant being either propagated by a seed the following 
spring, or else sending fresh shoots from its still 
living root. 

Of the very many species which have been extolled 
for their medicinal virtues, we have selected only 
such as by their wide distribution and long-tried use 
have acquired a permanent and well-recognized value, 
and can readily be obtained in nearly all parts of our 
country. 

CALAMUS. 

Calamus, or sweet flag, abounds in low, wet, and 
swampy places, and is well known by its pungent, 



736 ON MEDICINES. 

aromatic taste. It is a very convenient and useful 
article in domestic medicine, especially well adapted 
to relieve pain or uneasiness of the stomach or bowels 
arising from flatulence and where there is weakness 
of those organs. Children do not object to its taste, 
and they will readily take it in the form of a tea, 
sweetened, or scraped and mingled with a little sugar. 
We know a physician of wide experience who prefers 
it to any other substance in the treatment of colicky 
infants. 

DANDELION. 

In pharmacy, this common plant is known as Ta- 
raxacum, and it is justly esteemed one of the most 
useful domestic contributions to the materia medica. 
The organs on which it exerts the most decided influ- 
ence are the liver and the kidneys. Hence it is of 
service in jaundice, biliousness, and chronic inflamma- 
tion of the liver; and also in dropsy and inflammation 
of the bladder. In habitual constipation and in coughs, 
which are connected with a torpid liver, it also deserves 
a trial. 

The most efficacious part of the plant is the root, 
which should be collected in July, August, or Sep- 
tember, and used, if possible, in its fresh state, as it 
loses somewhat on drying. A strong infusion may be 
drunk freely, or the root may be dried and mixed with 
coffee, though this lessens its strength. A "fluid ex- 
tract" of it is sold in the shops, which, if carefully 
prepared, acts well. 



MEDICAL USES OF DOMESTIC HERBS. 737 



FLAXSEED. 

■ Linseed, or flaxseed, is so familiar to every one, that 
it needs no description. Hardly a housekeeper but 
professes to understand how to make flaxseed tea and 
a flaxseed poultice. But it is our experience that few 
of them really do. To make the tea, instead of 
throwing the seeds into a vessel of water and boiling 
for a given time, they should be placed in a small 
linen bag, and suspended in the fluid by means of a 
string. The vessel should be perfectly clean, and 
covered during the process. Three tablespoonsful of 
seeds will be enough for a quart of water, and the 
latter should be boiled twenty minutes. A few slices 
of lemon should be added to give it a flavor. 

Flaxseed tea is useful in coughs and colds, in dis- 
orders of the bowels, kidneys, and bladder, and gene- 
rally where we wish to administer soothing and nour- 
ishing drink. 

The poultice should be made by stirring very 
gradually flaxseed-meal into boiling water, until it is 
the proper thickness. In applying it, a little sweet 
oil or lard may ~be added to prevent it drying and 
adhering to the skin, and also to render it more soft 
and soothing (see page 519). 

FLEABAXE, OR SCABIOUS. 

The botanical name of this plant is Erigeron. 
Several species of it abound in the Middle and North- 
ern States, possessing similar remedial powers. These 

47 



738 OST MEDICINES. 

are chiefly directed to exciting the action of the kid- 
neys and skin. Hence the herb is useful in dropsy, in 
gravel, after an attack of pleurisy, etc. A pint of the 
tea, drawn from an ounce of the herb, may be taken 
every day. The oil of the plant has also been found 
useful, in doses of five drops every two hours, to control 
flooding; but it must be administered with caution. 



GAELIC. 

The remedial powers of this vegetable have been 
known from the most ancient times, and are still 
recognized. One of the oldest of its uses is to the 
spine of young children affected with hooping-cough. 
The fresh bulb is cut in half, and the cut surface 
rubbed thoroughly up and down the spine. A syrup 
of garlic, made by adding white sugar to the juice and 
gently simmering the mixture, is often beneficial in 
hard coughs, colds, and to old asthmatics. For coughs 
in children it is particularly well adapted, and it also 
has the power of expelling worms from the bowels, 
and is often used for this purpose. 

The external uses of garlic are numerous. Bruised 
and applied to the feet, it acts very beneficially in 
disorders of the head, and in children who are feverish, 
restless, and with a tendency to wandering of the 
mind. A few bulbs bruised with a little hot vinegar, 
and laid over the bladder, will readily excite a 
discharge of urine in young children and also in 
adults. A bulb cut in two pieces, and the fresh 
surface applied to a spot stung by a wasp, bee, or 




To face p. 739. 



Hops (p. 739). 



MEDICAL USES OF DOMESTIC HERBS. 739 

mosquito, will promptly allay the irritation and abate 
the pain. Swellings and slow tumors are sometimes 
readily dispersed by rubbing them frequently w T ith a 
sliced bulb, and the same treatment has been recom- 
mended to promote the growth of the hair. The 
offensive smell is the only drawback to its use. 

HOPS. 

The botanical name of this plant is Humulus lupulus. 
From ancient times it has been known to possess 
soothing and sleep-producing qualities. A cup of 
strong hop tea insures a night's rest, and some have 
found a hop pillow to exert the same effect. An old 
physician informed us that in the severe pain of 
carbuncle in old people he had found nothing more 
effective than the pollen of hops — the dust which falls 
off when they are shaken — mingled with syrup. The 
dose of the pollen is a teaspoonful. 

As a local application to a bruise, a sprain, an 
inflamed joint, or the mumps, a liop poultice will be 
found exceedingly grateful. To make it, stir the hops 
in boiling water, well salted, thicken with a handful 
of corn-meal, spread between two layers of thin 
muslin, and apply while hot. 



HORSERADISH. 

Used extensively as a condiment, this vegetable 
has curative properties also, which are worthy of 
notice. The green leaf as taken from the garden .and 



74:0 ON MEDICINES. 

soaked in hot vinegar or water, will, when applied to 
the skin, quickly redden and sometimes blister it. In 
cases of hoarseness, a syrup prepared by boiling the 
fresh root, straining, and adding sufficient sugar, 
will be found of advantage. It should be slowly 
swallowed in the quantity of one or two teaspoonsful, 
repeated as occasion demands. 

The infusion of the root may also be given with 
advantage in dropsy, old cases of rheumatism, and in 
palsy. 

LETTUCE. 

The common garden lettuce yields a useful medi- 
cinal substance in its juice. It is obtained by wound- 
ing the white, solid, central portion of the mature 
plant. A milky juice flows out, which thickens and 
congeals after exposure to the air and sun. Its taste 
is bitter and its color a dark brown. The best is 
obtained when the pl&nt is in flower. It is called 
Lactucarium. 

Its properties are similar to those of opium, with- 
out the unpleasant after-effects of the latter drug. It 
soothes the nerves, and induces a quiet and profound 
sleep. A piece about the size of a buckshot is an 
ordinary dose. For those who cannot take it in this 
form, it may be powdered and mixed with sugar and 
water, and flavored with ginger. Some families pre- 
pare it for domestic use, and employ it in preference 
to all other drugs to induce sleep. 



MEDICAL USES OF DOMESTIC HERBS. 741 



LOBELIA. 

This very common plant, known also as Indian 
tobacco, has achieved a popularity as a domestic 
remedy which it is far from deserving. By a certain 
class of practitioners it has been vaunted as a cure-all, 
and recommended for almost every complaint. Con- 
sequently it has done much more harm than good. 
As it is violent in its action, and fatally poisonous in 
overdoses, there have been numerous instances where 
death or a long illness has been directly traced to its 
incautious employment. 

Its chief action is to nauseate and cause vomiting, 
and to stupefy the brain. The diseases in which it 
can be employed with benefit are asthma, long-standing 
coughs, lockjaw, and dropsy. The safest method to 
administer it, for those not physicians, is to make a 
tea by pouring a quart of boiling water on the leaves 
and stalks, and of this give a teaspoonful every 
quarter of an hour until sickness of the stomach is 
produced. 

PARSLEY. 

Parsley is cultivated in most kitchen-gardens for 
culinary purposes. It possesses also some well-marked 
medical virtues. The root, taken in the form of a 
strong tea or infusion, acts gently upon the bowels 
and the kidneys, and is of service in dropsy and 
diseases of the bladder and kidneys. The eminent 
Professor Chapman, of Philadelphia, was accustomed 
to recommend it highly in these complaints. 



742 ON MEDICINES. 

The juice of the fresh herb, and the seeds, have been 
successfully employed in fever and ague, and other 
complaints arising from exposure to swamp-poison. 
Where persons are not able to obtain quinine, these 
furnish useful substitutes. 



PEPPERMINT. 

Peppermint and spearmint are alike in their proper- 
ties. They are among the most useful domestic plants 
which are found, and have a well -deserved popular 
reputation. They allay sickness of the stomach, re- 
move colicky pains, drive out wind, and cover the 
taste of unpleasant medicines. The fresh herb, bruised 
and applied to the stomach, often allays sick stomach, 
and is useful in the cholera of children. The virtues 
of the plant reside in an oil. This can be bought sepa- 
rately. Its dose is two or three drops mingled with 
water and sugar. As an external application, it is of 
great efficacy in curing neuralgia; a little of it being 
smeared over the surface where the pain is felt. 

The essence of peppermint commonly sold in the 
shops is made by dissolving this oil in alcohol. It is 
the most convenient form to use the mint, and may be 
given in doses of ten or twenty drops on a lump of 
sugar. 

PODOPHYLLUM. 

The mandrake, May-apple, or hog-apple, called by 
botanists Podophyllum, has recently grown into con- 
siderable favor as a medicine. The dried root of the 



MEDICAL USES OF DOMESTIC HERBS. 743 

plant is used, which has a purging or cathartic action 
on the bowels, not attended with much griping. The 
dose of the root when powdered is about as much as 
will fill a teaspoon; or it can be used in the form of an 
infusion, an ounce to the quart, a small wineglassful 
of which can be taken until it operates. Some persons 
are very much more readily affected by it than others 
so due caution must be exercised. 

The complaints in which it is held to be most effica- 
cious are those which arise from a torpid condition of 
the liver, as it is supposed to be peculiarly efficacious 
in removing the bile from the system. 

SAGE. 

In ancient times, sage was very highly esteemed 
for its healing virtues. One of the old writers puts 
the question, "Why should a man die when he has 
sage in his garden?" But modern experience has not 
at all borne out this favorable opinion, and now we do 
not prize this plant nearly so much. 

Nevertheless, it has some properties which deserve 
to be mentioned. It is an excellent condiment to 
articles of diet, warming and strengthening the 
stomach. Sage tea is a valuable remedy for children 
who suffer from wind, and, taken cold just before 
retiring, has a preventive influence on night-sweats. 
As a gargle in sore throat, it is often and beneficially 
employed, and, drawn mild, is a pleasant and refresh- 
ing drink in feverish conditions. 



744 



ON MEDICINES. 



SENEKA SNAKEROOT. 

There are several different plants known as "snake- 
root." That which we consider here is called by 
botanists Poly gala senega. It is an annual plant, 
from nine inches to a foot in height, with small white 
flowers. It grows wild in all parts of the United 
States, and is collected for sale in the South and "West. 

Some have recommended it as a cure for the bite of 
the rattlesnake, and hence it derived its name. But 
it cannot be depended upon to protect from this 
venomous serpent. The most valuable property it 
possesses is as a cure for coughs and colds, especially 
those of long standing. A handful of the root, and 
a handful of liquorice-root, should be boiled together 
in half a gallon of water for half an hour and then 
strained. A wineglassful of this three or four times 
a day will often act in a very satisfactory manner. 
"Where there is a loss of voice and hoarseness, this may 
be used as a gargle. 

Some physicians recommend it to bring back the 
monthly sickness in young girls. For this purpose a 
strong tea of it should be drunk, to the extent of a 
pint in the twenty-four hours, for several days prior to 
the expected discharge. 

THORN-APPLE. 



This plant, Stramonium, is more familiarly known as 
the Jimson-weed or Jamestown-weed. It grows three 
or four feet in height, and the whole plant has an 




Belladonna Berry 
(p. 749). 



Thorn-Apple (p. 744). 





Mustard (p. 710). 



Fleabane (d. 73' 



To fact -p. 744. 



MEDICAL USES OF DOMESTIC HERBS. 



745 



unpleasant fetid odor. All parts of it are poisonous, 
and a number of cases are on record of children and 
families who have been poisoned by eating the berries, 
and by taking the leaves in mistake for greens. 

In domestic medicine the plant should not be given 
internally, on account of the dangerous consequences 
which might result. Bat its most efficient properties 
can be employed without having recourse to this 
method of administration. 

One of its most valuable uses is in asthma. To 
prepare the roots for this use, they are dried, cut into 
pieces, and beaten so as to loosen their texture. The 
dried leaves answer the same purpose. They are 
smoked by means of a common tobacco-pipe when 
the attack of asthma comes on. They have also been 
used in the shape of cigars. Thorn-apple is sometimes 
of service in old coughs. 

Externally, an ointment made by simmering the 
leaves in* clean lard and then straining has been 
advantageously used in painful sores, swelling of the 
breasts, and piles. 

TA^ST. 



Although this herb is now so abundant in this 
country, it was originally introduced from Europe. 
Its odor is strong and peculiar, the taste bitter and to 
many unpleasant. Its principal value in medicine is 
as a vermifuge. A strong tea prepared from the seeds 
can be administered in the same manner as wormseed. 
The tea is also an excellent bitter tonic in cases of 
debility. 



746 



ON MEDICINES. 



The oil of tansy is sometimes used to bring back 
suppressed periods, but for this purpose it is entirely 
inefficient, and, as it is poisonous, it should never be 
taken. Several deaths from doses of from one to four 
teaspoonsful have been recorded. 

VIRGINIA SNAKEROOT. 

This variety of snakeroot is readily distinguished 
from that which we have already described as SeneJca 
snakeroot The root of the latter is grayish, and is in 
single pieces often of the thickness of the little finger, 
with but few branches, and these of considerable size. 
The Virginia snakeroot, on the other hand, has a 
great number of very small fibres and rootlets, not 
thicker than a thread or small twine, which branch out 
from a small knob, and are brown in color. 

A strong tea of the Virginia snakeroot is useful as 
a gargle in sore throat, and to bring out the eruption 
in scarlet fever and measles. "When warm, it acts on 
the skin, promoting perspiration, and can be given 
with advantage at the outset of a cold, and in old 
cases of rheumatism. When taken cold, it is a gentle 
tonic, useful in the convalescence from fevers, and has 
been recommended in fever and ague. 

WORMSEED. 



"Wormseed is the product of the common domestic 
plant which goes by that name, and is also called 
the "Jerusalem oak;" by botanists, Chenopodium. In 



MEDICAL USES OF DOMESTIC HERBS. 747 

Maryland and elsewhere it is cultivated as an article 
of commerce, and an oil is distilled from the seeds. 

As its name denotes, the peculiar virtue of the plant 
is its power to expel worms from the bowels. This it 
does efficiently. The most convenient method of giving 
it to children is to powder about a teaspoonful of the 
seeds, and mix them with a sufficient quantity of mo- 
lasses. A wineglassful of the decoction prepared by 
boiling an ounce of the fresh leaves in a pint of milk, 
with the addition of a little calamus or orange-peel to 
conceal the taste, is sometimes substituted in domestic 
practice for the ordinary dose of the seeds. Either 
dose should be repeated morning and evening for 
several days, and then followed by a full dose of castor 
oil or other purge. 



The more Important Chemical and Foreign 

Drugs. 

The crowded shelves of the drug stores present such 
an array of unknown names and mysterious substances, 
that the novice may well despair of being able to 
make use of them by any brief course of study. But, 
in truth, most of these articles are of rare or equivocal 
value, and a score or two of bottles contain substances 
worth more than the whole remainder of the stock, for 
practical purposes. 

The names of the greater number of the most highly 
esteemed drugs are already familiar to every reader, 
and all that he requires is to fix in his memory their 



748 ON MEDICINES. 

special applications, and the quantities or doses in 
which they should be administered. 

They are derived from two sources. Either they 
are vegetable products obtained from plants of tropi- 
cal or foreign growth, or they are derived from the 
inorganic elements in some of their chemical combi- 
nations. 

For the sake of convenience in arrangement, and 
as such a division will aid in retaining them in the 
memory, we will classify them under the headings 
of "vegetable drugs," and "mineral and chemical 
drugs." 

1. VEGETABLE DRUGS. 

Most of these are obtained in the tropical regions 
of the earth. 

ALOES. 

This drug is obtained from the leaves of an herb 
growing in the "West Indies and other tropical 
countries. The inferior varieties are known as " horse 
aloes," being only used in veterinary medicine. The 
best is of a reddish-brown color, with a bitter taste 
and strong fragrant odor. When powdered, it has a 
beautiful golden-yellow hue. 

In small doses aloes is a tonic to the stomach, 
bowels, and liyer, and is of especial value in habitual 
constipation. In larger doses it is a stimulating 
purgative. The dose is from two to twenty grains ; 




Aloe (p. 748). 




To face p. 74S. 



Aloe (p. 748). 



VEGETABLE DRUGS. 749 

on account of its bitterness, it is most easily taken in 
the form of a pill. 



ASSAFCETIDA. 

This is the gum of a large plant found in Persia 
and the adjacent countries. It comes in lumps of 
different sizes, brownish-yellow in color, and possess- 
ing the powerful, garlicky, disagreeable odor which 
is never forgotten by one who has been obliged to 
swallow the substance. The taste is bitter and un- 
palatable, but its medical virtues are unquestioned. 
In nervous diseases of females, some forms of convul- 
sions, in wind colic, especially in elderly people and 
children, and hooping-cough, it is very efficacious. 
The dose of the powder is from five to ten grains, but 
often we can derive the effects of the medicine by the 
more agreeable method of using it externally, as a 
plaster. The powder can be mixed with lead plaster 
and wax, and applied over the stomach or chest. 

THE DEADLY NIGHTSHADE. 

This beautiful plant is called by botanists Bella- 
donna, beautiful woman, the name being derived, it is 
said, from an Italian cosmetic into which it entered 
largely. It is a native of Europe, but grows wild in 
many parts of the United States. 

The ominous name which it bears is justly given 
it on account of its poisonous qualities, which are 



750 ON MEDICINES. 

marked, and consequently the utmost caution must be 
exercised in its employment for medical purposes. 

It is used in the form of an ointment to relieve the 
pain of neuralgia, and to disperse the cold swellings 
which characterize various inflammatory diseases of 
a chronic nature. In the latter stages of hooping- 
cough, small doses are occasionally employed with good 
results. Its most valuable property, however, consists 
in its power as an antidote to opium. This will be 
spoken of more at length, as well as the antidotes to 
the herb itself, in the section on Poisons and their 
Antidotes. The powerful poison, atropia, is the active 
principle of belladonna. 

The dose of the powdered leaves is one grain twice 
a day ; of the extract or juice, one-fourth of a grain. 
"We do not recommend, however, the employment of 
such a dangerous remedy, except where a physician 
has been consulted. 



CAMPHOR. 

Camphor is a product obtained from a tree which 
grows in China, Japan, and other portions of eastern 
Asia. It is a popular drug for both external and in- 
ternal use, but must be employed with caution, as an 
overdose of it has been known to prove fatally poi- 
sonous. 

For external use, it is usually dissolved in alcohol 
or spirits, but may also be applied in a powder. This 
latter form is valuable in some skin diseases attended 
with violent itching. It may also be sprinkled on 




To face p. 751. 



Pepper. 



VEGETABLE DRUGS. 751 

poultices and plasters. In rheumatism, enlarged joints, 
bruises, and sprains, spirits of camphor are of decided 
value, either alone or with some laudanum. 

Internally, camphor is found in most of the popular 
remedies for colic and diarrhoea. Half a teaspoonful 
of the spirits or tincture is an average dose. 

CASTOR OIL. 

The seeds of the Palma Christi, an annual plant 
extensively cultivated in all parts of the world, yield 
castor oil. It is a thick fluid, without color when 
pure, and with a mild nauseous taste. As a mild and 
efficient laxative it has no equal, and is especially use- 
ful where the object is to empty the bowels without 
causing griping or irritation. What is known as the 
"cold drawn" or expressed oil is the best. 

The chief objection to its use is its unpleasant taste. 
This can be concealed in several ways. One of the 
best is to take the oil in the froth of porter. Strong 
coffee, and essence of peppermint, also hide its flavor 
very successfully. In administering it to children and 
women, these precautions should not be disregarded. 
The dose for children is from a teaspoonful to a tabie- 
spoonful; for adults, one or two tablespoonsful. 

CINNAMON. 

Cinnamon is the inner bark of a tree which grows 
in Ceylon and other portions of the East Indies. It 
is generally used as a spice or condiment in food, but 



752 ON MEDICINES. 

also possesses medicinal properties which deserve to 
be known. 

In colic, vomiting, diarrhoea, and similar disorders of 
the stomach and bowels, it is a grateful and efficient 
remedy. A drop of the oil of cinnamon introduced 
into a decayed tooth occasionally will arrest the tooth- 
ache. Added to other medicines, and to articles of 
diet for the sick, it improves their taste, and gives a 
gentle stimulant to the stomach. 

FOXGLOVE. 

The botanical name of this plant is the Digitalis 
purpurea , and although a native of Europe, it is fre- 
quently cultivated in gardens in this country. In 
many respects it is a valuable drug, but it must be 
employed with caution, as it is poisonous in large 
doses. 

In diseases of the heart it is a potent remedy, being 
of value when there is much palpitation and weakness 
of that organ. Its effects on the kidneys are quite 
marked, bringing about promptly a flow of urine. 
Hence it is esteemed in cases of dropsy, and absence 
of action of the bladder, or suppression of urine. In 
many cases where there is a long-continued feverish 
action and considerable nervousness and sleeplessness, 
small doses of digitalis repeated for a number of days 
bring about decided relief. 

The dose of the powdered leaves is one grain; a 
drachm of the leaves to a quart of boiling water makes 



VEGETABLE DRUGS. 753 

a tea which may be taken in doses of three or four 
teaspoonsful. 

JALAP. 

The root of a Mexican plant, long known to the 
aborigines, furnishes jalap. The powder of the root is 
of a pale yellow color, and has a sweetish taste and a 
peculiar heavy odor. 

For many years this powder in from ten to twenty 
grain doses was a very popular purgative in the West 
and South, and there are few old residents there who 
have not swallowed their share of "calomel and jalap." 
Of late years this active mixture is less called for. 
Jalap is certainly a safe and efficacious purgative, 
especially useful in dropsy, and when it is desired to 
act thoroughly on the system. 

IPECAC. 

The plant which furnishes the ipecacuanha root is a 
native of Brazil, and has long been known to the 
Indians there as possessing important remedial powers. 
Few drugs are more valuable, and it can be used with 
advantage in a great variety of diseases. In large 
doses (twenty grains) it is a mild, safe, and certain 
emetic; in smaller ones (one or two grains) it acts on 
the lungs and skin, promoting perspiration; and in 
still smaller doses (one-sixth to one-eighth of a grain) 
it is a valued tonic. Large doses of it (thirty to 
forty grains) have been used with marked success in 
dysentery, and in less quantities it forms a part of 

48 



754 ON MEDICINES. 

most cough mixtures. A few grains of it taken at 
the outset of a cold will frequently check it entirely. 
One of its most convenient forms is that of syrup of 
ipecac. It is chiefly applicable to children. The dose 
as an emetic is half a teaspoonful; for a cough, five 
drops ; for adults, three times these quantities. 

OPIUM. 

There is probably not another drug which has so 
many and valuable applications in medicine as opium. 
It is the juice of the unripe seed-cups of the Poppy, a 
plant originally a native of Persia, but now growing 
wild or extensively cultivated in this country and 
Europe. It is from two to five feet in height, with 
large white or violet-colored flowers. 

Opium comes in dark-brownish masses of various 
sizes, with a strong pungent odor and a bitter taste.. 
"When it is dissolved in alcohol or strong spirits it 
forms laudanum, or tincture of opium ; and morphine 
or morphia is the active principle, separated from the 
gum, and purified; it is about four times as strong as 
the opium itself. 

In small doses this substance is a stimulant, 
increasing the heat of the body, and producing a 
peculiar exhilaration of the mind akin to intoxication. 
The brain becomes active, is crowded with pleasing 
ideas, and a sensation of comfort pervades the system. 
These effects, however, soon subside, and are followed 
by mental depression and languor, drowsiness, and 
sleep. On awakening, there is a sense of fulness and 



MEDICAL USES OF OPIUM. 755 

often pain in the head, sickness of the stomach, loss 
of appetite, and unfitness for exertion. "We have 
already referred (see page 114) to the vice of opium- 
eating or laudanum-drinking, and its ruinous effects 
on body and mind, so we shall here confine ourselves 
to its employment as a medicine. 

This must always be commenced with caution. 
Some persons are peculiarly sensitive to the effects of 
opium, and others cannot take it at all without suffer- 
ing from a painful excitement and a prostrating re- 
action. Especially with children should the utmost 
care be used, because they are always very easily 
overcome by even small doses. 

As a general rule, opium may be resorted to where 
the object is to relieve pain, soothe nervous irritation, 
or procure sleep. In diarrhoea, dysentery, and exces- 
sive action of the bowels, it stops the purging and 
quickly effects a cure. At the outset of a severe cold 
in the head, a full dose will almost certainly check it 
completely. In neuralgia, rheumatism, and gout it is 
constantly employed. In fact, there is hardly a disease 
which does not occasionally present symptoms de- 
manding its use. But in affections of the brain, 
during pregnancy, and in infants, it should be avoided 
unless imperatively called for. 

The average dose of opium, for an adult is one grain 
either in pill or powder; children from five to ten 
years must not take more than a quarter of this 
amount; and those under five, not more than one- 
tenth as much. Twenty drops of laudanum equal in 
strength one grain of opium, and may be administered 



756 ON MEDICINES. 

accordingly. The "deodorized tincture of opium" is 
an excellent preparation, free from certain noxious 
ingredients in laudanum and in the crude drug. It 
is of the same strength as laudanum. "Paregoric 
elixir" is a popular combination of opium, camphor, 
oil of anise, honey, and alcohol. Each tablespoonful 
contains one grain of opium, and equals therefore 
twenty drops of laudanum. It is much used to allay 
troublesome coughs, and to relieve nausea, colic, and 
slight diarrhoeas. The dose for an adult is one to two 
teaspoonsful ; for an infant, five to twenty drops. 
" Dover's powder," frequently used at the outset of 
colds, contains one-tenth part of opium; dose ten 
grains. 

The poisonous effects of opium, and the remedies to 
be used to combat them, will be mentioned hereafter. 



PERUVIAN BARK AND QUININE. 

Peruvian bark is obtained from the cinchona-tree, 
a native of the Andes in South America. The dif- 
ferent varieties are known in commerce as Red bark, 
Yellow bark, etc. The active ingredient of the bark 
is the well-known substance quinine, which is at pre- 
sent one of the most extensively used articles in the 
materia medica. In appearance, it is a light, white 
powder, and is now employed almost invariably in 
preference to the Peruvian bark itself. 

In small doses (one to three grains) quinine im- 
proves the appetite and promotes the digestive powers, 
without producing any other marked effects on the 





To face p 756 



Cinchona (p. 756). 



MEDICAL USES OP QUI^IXE. 757 

system. In larger or long-continued doses it causes 
headache, deafness, ringing in the ears, and similar 
symptoms, a condition known as " quininism." As a 
tonic it is useful in all cases of debility where there is 
no tendency to inflammation or bleeding. 

But its chief value is to break up fevers caused 
by swamp-poison, such as fever and ague, breakbone 
fever, remittent fever, etc. It is best to give it in full 
doses (ten to twenty grains) during the intermission ; 
but, if necessary, it may be given at any stage of the 
disease with safety, and sometimes with advantage. 
In the intermittent fevers of the Southern Sates it is 
very common to rely on one large dose given shortly 
before the chill comes on ; but it is wiser to resort to 
moderate doses (five grains) more frequently repeated. 
It also possesses great powers as a preventive against 
malarial diseases, as we have previously stated. In 
neuralgia and rheumatism it is also often given with 
manifest advantage. 

Of the numerous preparations of this drug we may 
mention " Huxham's tincture of bark" (dose, one to 
four teaspoonsful) as an excellent tonic cordial. To 
conceal the taste of quinine, powdered liquorice is one 
of the best additions. 



RHUBARB. 

The rhubarb which is used as a drug is the root of 
a species of the plant which is cultivated in Asia and 
Europe. The best is of a bright yellow color, with a 
slightly aromatic odor. 



758 ON MEDICINES. 

It is a deservedly popular medicine, chiefly taken to 
act upon the bowels, which it does in a mild and effi- 
cient manner. The aromatic syrup of rhubarb is one 
of its most agreeable forms, especially for children 
(dose, a teaspoonful for an infant; a tablespoonful for 
an adult). In the form of a powder, five to twenty 
grains may be taken at once. Many persons troubled 
with wind on the stomach, and with a tendency to 
constipation, find relief by chewing a little rhubarb 
after meals. A piece can be carried in the pocket for 
the purpose. 

SENNA. 

Senna is the leaves of a small tree which grows in 
Arabia and northern Africa. It has a faint, sickly 
odor, with a slightly bitter taste, and affords a greenish 
powder. It is a sure and safe purgative of moderate 
power, but inclined to cause some griping in the 
bowels. For that reason it is better to combine it 
with some aromatic substance and a saline laxative. 
The favorite mixture, "salts and senna," is a good 
one, and acts very well where a decided purgative is 
required. 

The most pleasant form to take the drug is that 
known as the " confection of senna," an excellent laxa- 
tive, without unpleasant flavor, and well adapted to the 
costiveness of pregnant women. The dose is about 
two teaspoonsful. 



MINERALS AND CHEMICALS USED IN" MEDICINE. 759 



2. MINERAL AND CHEMICAL DRUGS. 

These may be either natural products, or prepared 
in the laboratory of the chemist. 



BROMIDE OF POTASSIUM. 

The chemical product which bears this name is 
a white salt with a pungent, saline taste, readily 
dissolving in water. 

Its most important action on the system is of a 
soothing and quieting character, diminishing nervous 
excitement, and producing a quiet, refreshing sleep. 
Where the want of sleep arises from mental anxiety 
rather than physical suffering, it is a remedy of great 
power and happy effect. Those headaches which result 
from excessive mental strain, and from over-indul- 
gence in alcohol, yield to it readily. Long continued 
and in full doses, it is really the only remedy which 
will cure epilepsy. In the convulsions of children, 
and in hooping-cough, its influence is likewise bene- 
ficial. 

One of its most curious properties is its effect on 
the sexual powers, diminishing their function in a 
remarkable degree. Hence it is of peculiar service in 
some nervous diseases of youth, which take their rise 
in premature and undue excitements of that character. 

Unlike most other sleep-compelling remedies, there 
is little or no danger in its administration, as even in 
overdoses its results are not fatal. The usual dose 
is twenty or thirty grains (about a half teaspoonful) 



760 ON MEDICINES. 

dissolved in water. This may be repeated hourly 
until sleep is obtained, or the symptoms disappear. 
For a child under ten, the fourth of that amount will 
be ample. 

CALOMEL. 

Calomel is one of the forms of the mineral mercury, 
or quicksilver. It is a white, heavy powder, without 
smell or taste. 

Probably no drug in the whole catalogue has 
experienced more violent changes in popular favor 
than this one. In the early settlement of the "Western 
and Southern States it was almost the only drug used 
"to act on the liver," and at the same period it was 
quite as much in vogue in the Eastern States and in 
England. In many instances it was used carelessly 
and in excessive quantities, leaving behind it a state 
of mercurial poisoning, which the patient did not 
recover from for months and years, if ever. So much 
was said of this abuse of its potent properties, that 
patients became afraid to take it, and physicians 
hesitated to administer it. The surgeon-general of 
the army struck it from the medical supply list, and 
quacks made a point of assuring the public that they 
dealt exclusively in vegetable remedies. 

Both these extremes have now passed away, and 
although we recognize the necessity of using calomel 
with much prudence, we also acknowledge that at 
times it is the very best remedy that can be chosen. 
In doses of five to ten grains it is an efficient purga- 



CHEMICAL DRUGS. 761 

tive, relieving that sense of dulness and languor 
known as "biliousness/' and acting promptly on the 
liver. Certain chronic skin diseases and digestive 
disorders of long standing are much benefited by its 
administration in very small daily doses (one-fourth 
to one-half of a grain) long continued. Sprinkled 
on wounds in which maggots have effected lodgement, 
it will rapidly expel them; and for the destruction of 
those disgusting parasites known as "crab lice" it is 
almost the only substance which is effective. 



CARBOLIC ACID. 

This substance is obtained from coal-tar. As usually 
met with, it is a colorless oily-looking fluid, of a slight 
tarry and aromatic odor, resembling that of coal-tar, 
with a sharp, burning taste. 

Its introduction into the materia medica is compara- 
tively recent, but it possesses so many valuable pro- 
perties that the amount of it used has vastly increased 
within a few years. Its powers as a disinfectant are 
very marked, and have been referred to by us in the 
earlier pages of this work. 

In domestic practice, its employment should be 
confined to disinfecting purposes, and to external 
applications, as it is an active and dangerous remedy 
internally. A small teaspoonful rubbed up with two 
tablespoonsful of clean lard makes an excellent oint- 
ment for unhealthy wounds, old sores, and ulcers, and 
will also very soon cure the itch, scalled head, and 
many obstinate skin diseases. An equally beneficial 



762 ON MEDICINES. 

wash or lotion may be made by adding a tablespoon- 
ful of the acid and an equal quantity of alcohol to a 
pint of pure water. This destroys parasites, as lice, 
fleas, etc., at once, and can be applied to ulcers, etc., 
with the best success. 



CHLORAL. 

One of the most recent discoveries of importance 
in materia medica is the drug termed chloral. For 
many years it was familiar to the chemist, but only 
lately its power to soothe and to produce sleep has 
become generally appreciated. 

In appearance it is a white salt, possessing a sharp, 
burning taste. On exposure to the air, it undergoes 
changes which deteriorate its quality, and it also loses 
some of its powers when dissolved in water for any 
long time. Hence it is well to preserve it in a closely 
stopped bottle, and dissolve it as required. 

With most persons it acts very pleasantly, removing 
nervous excitement, calming the mind, and producing 
undisturbed and refreshing slumber. It does not dull 
the sense of pain to the extent that opium does, but it 
has not the unpleasant after-effects which so frequently 
follow the use of the latter drug. "We have found ex- 
ceptional persons who, however, found it impossible to 
take chloral without experiencing nausea and headache 
the next day. 

The drug is not to be carelessly employed, as quite 
a number of deaths, both of children and adults, have 
been reported from inordinate doses. With grown 



CHEMICAL DRUGS. 763 

persons, ten-grain doses are sufficient to begin with, 
to be increased to fifteen or twenty ; and for children 
under ten, a grain for each year of the age is a safe 
allowance. 



CHLORATE OF POTASH. 

A somewhat complicated chemical process is re- 
quired to prepare this substance. It is in appearance 
a white salt, without odor, and with a cool taste not 
unlike saltpetre. 

The special value which it has in medicine is in the 
treatment of sore throat, scarlet fever, diphtheria, and 
all forms of soi^e mouth. A teaspoonful dissolved in a 
pint of water should be at hand in all these diseases, 
and should be employed every hour or two both as a 
gargle and also as a daily drink. No more generally 
efficacious mixture can be found in these cases. 



IRON. 

This most abundant and familiar metal is found in 
the blood, and is an important constituent of the 
human system. Certain diseases and impaired condi- 
tions of the health are found uniformly associated 
with a deficiency of it, and naturally enough, therefore, 
its administration as a remedy was suggested by this 
fact. But long before this was known, experience 
had adopted it as one of the most efficient tonics with 
which we are acquainted. 

Iron rarely occurs pure in nature, but generally as 



764 ON MEDICINES. 

an ore. Many mineral waters contain it in small 
quantities. They are called chalybeate or ferruginous 
waters. There are also a large variety of combina- 
tions in which it is prescribed. 

Under its judicious use the appetite is increased, 
the digestion improved, the pulse strengthened, the 
color heightened, and the general health augmented. 

The simplest forms in which it is employed are 
iron filings and iron rust A simple and excellent 
tonic powder can be prepared by mingling equal parts 
of one of these and ginger, ten grains of which may 
be taken three times daily in a little sweetened water. 
For domestic practice, a tablespoonful of the iron 
scales which collect around the blacksmith's anvil 
may be placed in a gallon of hard cider, and a small 
wineglassful taken twice or thrice daily. 

MAGNESIA. 

The substance called "magnesia," or "calcined 
magnesia," is a light white powder, with little taste 
and no odor, not soluble in water. It is a mild laxa- 
tive, suitable to children, and in irritable states of the 
stomach. It is most readily taken stirred up with 
milk. The dose is a teaspoonful. For sour stomach 
and heartburn, one-fourth of this amount will be 
found a useful palliative. 



ACETATE OF LEAD AS A MEDICINE. 765 



SUGAR OF LEAD. 

The proper name for this is " acetate of lead." It 
is a white powder of a sweetish flavor, looking and 
tasting not altogether unlike some kinds of white 
sugar. It may be made by exposing thin sheets of 
lead to the vapor of vinegar. 

In small doses it soothes the system, and tends to 
constipate the bowels. Consequently it is useful in 
checking diarrhoeas^ dysentery, and other discharges, 
and in arresting bleeding at the lungs or stomach. 
The dose internally is one or two grains. 

Externally, a solution of sugar of lead, about a tea- 
spoonful to a quart of water, forms a soothing appli- 
cation to an inflamed surface, as after a sprain, blow, 
or bruise. A good wash for inflamed eyes can be 
made about the same strength. And chilblains and 
scalled head have been materially improved by apply- 
ing an ointment made by rubbing up ten grains of the 
acetate in a teaspoonful of clean lard. 



SULPHATE OF MAGNESIA, OR EPSOM SALTS. 

This salt is found in sea-water and in many mineral 
waters. Originally it was obtained by evaporating 
the waters of a mineral spring near Epsom in Eng- 
land, and hence the common name, "Epsom salts." 
It occurs in small transparent crystals, without odor, 
but of a bitter, salty flavor. 

In moderate doses (a tablespoonful), it is a mild 
and certain purgative, producing copious watery 



766 ON MEDICINES. 

passages. The most agreeable method to take it is in 
the form of the natural mineral-waters, which contain 
it in solution, as, for example, the Bedford Spring 
water of Pennsylvania, or the Congress water of 
Saratoga. 




CHAPTEE V. 

STANDARD DOMESTIC REMEDIES. 

The importance of reliable family medicines — The dangers and uncertainties 
of secret and patent medicines — How the legitimate demand for carefully 
selected domestic remedies may be met — The principles which should 
govern their selection ; Efficacy of the preparation ; Absence of dangerous 
properties; Avoidance of unpleasant taste; A convenient, compact, and 
portable form — The family anodyne recommended — The astringent — The 
purgative — The emetic — The expectorant — The stimulant — The tonic — The 
febrifuge — The diuretic — The antiperiodic — The vermifuge — The salve— 
The ointment for itch — The alterative. 




N" the list, in the preceding chapter, of drugs and 
other substances of medicinal virtue, will be 
found resources near at hand, and of undoubted effi- 
cacy for the treatment of the large majority of diseases 
to which persons are exposed in this country. But 
we are free to confess that we have not included in 
this list some of the drugs most powerful in curing 
disease, for the very sufficient reasons that they require 
a special knowledge to prepare and administer them, 
and that without this knowledge they are dangerous 
or useless. For it is well known that some of the 
most efficacious remedies are also active and subtle 
poisons, or else wholly inert unless properly prepared. 
Those who have taken an interest in the subject have 
fully appreciated how unfortunate it is that persons 
who are thrown upon their own resources in treating 
sick friends and neighbors must be deprived of the most 



768 STANDARD DOMESTIC REMEDIES. 

valuable remedies known to medicine, because they 
cannot safely be used. Intelligent physicians have 
long been convinced that it is on this account, more 
than any other, that injurious secret nostrums, under 
the name of patent medicines, have such an extensive 
sale, to the manifest disadvantage both of professional 
men and the public. Liberal and thoughtful medical 
men have for many years past urged that some plan 
be adopted by which standard and reliable active 
remedies be placed within the reach of the general 
public, with full directions for their use. 

As long ago as March, 1855, the editor of the 
Medical and Surgical Reporter, under the caption of 
" Domestic Medicines," wrote : " It is astonishing to 
what an extent the uncertain and often deleterious 
preparations styled Patent Medicines are consumed 
by all classes of society, and there is no question but 
such a wholesale consumption of drugs, having no 
guarantee of their purity or innocuity but that of a 
single mercenary individual, is calculated to do untold 
injury to the health of the community. But there is a 
demand for domestic remedies which these preparations 
are intended to supply, and the question arises whether 
this demand can be supplied in a manner that will 
guard against the venality of using drugs of uncertain 
properties or deleterious qualities. Let a committee 
be appointed by the American Medical Association to 
draw up a set of formulas for remedies calculated to 
meet the ordinary demands of domestic practice, and 
let these formulas be adopted by the American Medi- 



IMPORTANCE OF CARE IN FAMILY MEDICINES. 769 

cal and Pharmaceutical Associations, and published 
for the benefit of all concerned." 

The project at the time was warmly advocated by 
the American Medical Gazette and other leading 
authorities, but with no definite response from the 
associations to which the writers appealed. 

Within a very recent period the subject has been 
revived and its growing importance urged by The 
Journal of Materia Medica and other prominent 
periodicals. Our own attention has been drawn to it 
forcibly, and we are fully convinced that the adoption 
and general use in private families of a limited num- 
ber of carefully selected remedies, adapted for different 
trains of symptoms, prepared from pure and fresh 
drugs, and accompanied with full and plain directions 
for use, would be found to be of incalculable benefit 
to all. 

It were very much to be preferred, as the editor of 
the Medical and Surgical Reporter suggested, that a 
set of formulas suited to the ordinary demands of 
domestic practice be selected and indorsed by the 
chief medical association of the country. But during 
all these years that has not been done, and it is well 
known that there is no prospect of any such action 
being taken. The only resource left, therefore, is for 
some individual to undertake the task. 

It has been pressed upon us that there is no more 
suitable channel through which to recommend to the 
public the use of such selected remedies than in a 
work of the present character. And, influenced by 
the correctness of this view, as well as by the mani- 

49 



770 STANDARD DOMESTIC REMEDIES. 

fest propriety of placing within the reach of our 
readers all the best means with which to cure the 
diseases they may have to encounter, we have with 
great care made a selection of a limited number of 
Standard Domestic Remedies, which will meet all 
ordinary demands of home treatment. 

The principles which have guided us in this selec- 
tion are — 

1. Efficacy of the Preparation. — To secure this, we 
have taken a favorite recipe of some eminent physi- 
cian, in whose hands it has stood the test of a wide 
experience and by whom it has been recommended in 
decided terms. 

2. Absence of Dangerous Properties. — As these rem- 
edies are designed for family use, it is of essential 
importance that they be so compounded as to avoid 
endangering life even if taken carelessly or in ex- 
cessive quantities. As we have before stated, this 
is often difficult to accomplish, but by slight modifi- 
cations and occasional substitutions in the recipes 
selected, we believe we have accomplished this with- 
out subtracting at all from their value. 

3. Avoidance of Unpleasant Taste. — Too often, we 
are sorry to say, this principle is overlooked in writing 
prescriptions. A dose for a sick person should 
always be so combined with flavoring substances as to 
be rendered palatable to the taste whenever possible — 
and the rich resources of modern pharmacy render it 
possible in nearly all instances. "We have endeavored, 
by various minor and pleasant arts of the pharmacist, 



THE ANODYNE RECOMMENDED. 771 

to avoid disgusting the sense of taste even in taking so 
proverbially nauseous an article as a dose of medicine. 

4. A Convenient, Compact, and Portable Form. — Most 
medicines are administered in a fluid form. But this 
is merely on account of the greater readiness with 
which they are swallowed. They are much less 
compact, and more liable to breakage, than when pre- 
pared as powders. For this reason we have directed 
all our standard domestic remedies to be prepared in 
the latter form. "When they are taken, a portion can 
readily be dissolved in water or syrup. 

We have based the selection of the formulas upon 
these principles, and also upon the adaptability of the 
preparations to be used extensively in the treatment 
of various diseases. As we have before shown, the 
symptoms which the physician has to treat are not 
numerous, and many of them reappear in the large 
majority of complaints. The specifics, on the other 
hand, that is, those drugs which have the power of 
curing certain diseases almost without fail, are very 
few in number. 

THE ANODYNE.* 

The anodyne which we would recommend is a 
modification of the formula of Dr. Edward John 
Waring, F.L.S., an experienced London physician. 

It is composed of a small quantity of gum opium 
and bromide of potassium, combined with various 

* The precise formulas for the various preparations mentioned will be found 
in the appendix to the present work. 



772 STANDARD DOMESTIC REMEDIES. 

aromatics of a soothing character. The amount of 
opium being quite small, the deleterious effects of the 
drug are avoided, while the addition of the bromide 
of potassium not only increases the efficiency of the 
mixture as a sleep-producer, but also does away with 
the unpleasant after-effects which are produced on 
some constitutions by the use of opium even in very 
small quantities. The nausea, headache, loss of 
appetite, etc., which such persons experience, are 
happily prevented by the presence of the bromide. 

Such an anodyne may be used by an adult, in the 
doses mentioned, once every half hour until sleep is 
produced. But we do not recommend it, or any other 
preparation containing opium, for children under ten 
years of age. Sleeplessness and pain in their case can 
nearly always be remedied by simpler measures than 
the administration of opiates; and especially is it a 
good rule in domestic practice to avoid dosing these 
tender beings with a drug of such power. 

Adults may use this anodyne when they suffer from 
pain of any description, from nervousness and sleep- 
lessness, from excessive action of the bowels, or from 
sickness of the stomach. One such powder should be 
stirred in a wineglassful of water, and the whole 
swallowed. 

THE ASTRINGENT. 

We have already explained that an astringent is 
employed to check excessive action of the bowels in 
diarrhoea, dysentery, etc. That which we would re- 
commend as the best formula which can be employed 



THE CATHARTIC RECOMMENDED. 773 

for this purpose, in domestic practice, is a modification 
of the "compound catechu powder" of the Dublin 
Pharmacopoeia. The eminent German medical writer, 
Dr. Felix vosr Niemeyer, regards the modification 
which we have chosen as superior to any other which 
he had used in his extended experience. Gum catechu 
is an extract from the heart wood of a tree which 
grows in the East Indies. In the formula referred to, 
under this section, the gum or extract is associated 
with a certain amount of precipitated chalk, and with 
cinnamon and nutmeg, both aromatic species which 
serve not merely to conceal the somewhat harsh taste 
of the gum, but are themselves pleasant stimulants to 
the bowels and stomach. 

It is important to observe that neither this nor any 
other astringent should be used when there is any in- 
flammatory action of the intestines, which can readily 
be ascertained by the presence of tenderness on pres- 
sure. 

THE PURGATIVE. 

An active cathartic, that is, a medicine which will 
act promptly and efficiently on the bowels and relieve 
them of their contents, is of the utmost consequence 
in the domestic pharmacy. 

That which we have selected as well adapted to this 
purpose, and best suited to fulfil all the various pur- 
poses for which such a medicine is taken, is based 
upon a formula of Dr. J. M. Da Costa. 

It contains a small portion of rhubarb, one of the 
best foreign laxatives; a fraction of a grain of the 



774: STANDARD DOMESTIC REMEDIES. 

extract of the root of the May-apple, or podophyllum, 
which vegetable substance is now considered to act 
quite as efficiently on the liver as mercury, and to be 
free from the objections which many have urged to 
the latter drug; a moderate quantity of Eochelle salts, 
thus combining the peculiar action of the saline 
cathartics with those from vegetable sources; and a 
small portion of powdered red pepper, which serves as 
a grateful stimulant to the coats of the intestines. 

This cathartic may be taken every six hours until 
the effect is produced. It will not lead to an exhaust- 
ing diarrhoea, as is the case with some preparations of 
the kind, inasmuch as the rhubarb has a constipating 
power after its first effects are produced. 



THE EMETIC. 

The emetic which has been selected is that so highly 
recommended by Prof. Fordyce Barker, which 
depends for its efficiency on the presence of a few 
grains of turpeth mineral. Prof. Barker has found this 
so useful, simple, and harmless, that he has been ac- 
customed, as he mentions in one of his works, to 
have it made up in proper doses (the same which we 
have adopted), and to leave it with families, especially 
with such as have croupy children, with directions to 
employ it as required. 

Its value is not merely to relieve the breathing in 
croup, but in any case where there is need that the 
stomach be promptly relieved of its contents it may 



THE COUGH MIXTURE RECOMMENDED. 775 

be administered. Copious drafts of warm water will 
facilitate its action. 

Sometimes, at the very outset of severe diseases, the 
first step to take is to relieve the stomach of its 
contents by a prompt emetic. Dr. Bennett, of Edin- 
burgh, is of opinion that sometimes this procedure will 
greatly modify the violence of an attack, and even 
throw it off altogether. He instances a threatened 
attack of typhus fever in his own case, which he 
thinks was avoided by prompt recurrence to this 
preventive means. 



THE EXPECTORAXT. 

An efficient remedy for coughs and colds is indis- 
pensable in every household and in the trunk of every 
traveller. The numerous cough syrups, etc., recom- 
mended in the public papers, testify to the demand for 
such an article. 

The powder which we recommend for the purpose 
contains some of the most efficient drugs which can 
be selected to alleviate a cough and loosen the ex- 
pectoration. It is the judicious combination of one 
of the most skilful therapeutists of England, Dr. 
Edward John Waring-, whom we have already 
mentioned. 

The principal ingredients are powdered sal ammo- 
niac and senega-root. These are associated with a 
small amount of gum- Arabic and liquorice-root, also 
in powdered form. One such powder should be placed 



776 STANDARD DOMESTIC REMEDIES. 

in a half tumblerful of hot water, sweetened to the 
taste, and stirred until it is cool enough to drink. 

The bulky and often indifferently prepared syrups 
usually sold owe most of their efficacy to the sugar 
they contain, which lubricates and soothes the upper 
portion of the throat, and checks the tendency to 
cough temporarily. Most of them exert but a very 
small healing effect. Dr. Waring's formula, however, 
may be relied upon for its efficiency, and is not dis- 
agreeable to the taste. 



THE STIMULANT. 

In medical practice a stimulant is used to sustain 
or restore the powers for a temporary purpose and a 
brief period, as, for example, when there are symptoms 
of fainting, or where there is great exhaustion from 
the shock of an injury or loss of blood. 

The substance which is most generally relied upon 
for this purpose is the carbonate of ammonia, a very 
efficient salt which actively excites the vital powers, 
and relieves the sense of failing strength. In combi- 
nation with ginger, which is an aromatic stimulant of 
decided properties, it is presented in a formula by the 
late Dr. Thomas Hawkes Tanner, of London, which 
we have selected for our present purpose. 

The uses of such a preparation are somewhat 
limited, yet, when called for, highly important. It is 
often necessary to arouse the flagging powers suffi- 
ciently to administer food or some more potent medi- 



THE TONIC RECOMMENDED. 777 

cine, and for this purpose the carbonate of ammonia is 
perhaps the very best stimulant we possess. 

THE TONIC. 

"What a stimulant does for a few minutes, a tonic 
is intended to do permanently — viz., arouse and 
strengthen the physical forces. This must be done 
by directing our tonic to enriching the blood, in- 
creasing the appetite, and regulating the bowels. 

Among the very numerous formulas for tonics 
which have been urged upon the profession, we have 
selected that of the celebrated Dr. Abercrombie as 
answering these three purposes most completely, and 
as being, by its extended adoption among profes- 
sional men, deserving of its reputation. 

It is composed of sulphate of iron in the granulated 
form (which prevents change from exposure) ; a small 
quantity of aloes to regulate the bowels and prevent 
the constipation which so often accompanies debility; 
calumbo, which is a pure, bitter, vegetable tonic; and 
cinnamon, which is a grateful aromatic stimulant. 

In cases of chronic dyspepsia, general debility, 
want of tone to the system, and in the convalescence 
from almost all diseases, a tonic of this character will 
be found eminently beneficial. 

THE FEBRIFUGE. 

The uses of a febrifuge are to diminish the feverish 
sensations so frequent at the outset of a disease, and 
to promote perspiration. 



778 



STANDARD DOMESTIC REMEDIES. 



One of the most efficient ever devised is that pro- 
posed by Dr. Dover, and extensively known by the 
name of "Dover's powder." Its composition, however, 
renders it both unpalatable and too potent for delicate 
individuals in the doses usually prescribed. "We have, 
therefore, in adapting it to domestic use, employed 
several modifications which in great measure remove 
these objections, and we believe increase rather than 
diminish the activity of the preparation. 

The addition of a small quantity of nitrate of 
potassa we have found by experience to increase its 
action on the skin and kidneys; and the flavoring 
substances which can be added, almost completely 
mask the disagreeable taste of the compound. 



THE DIURETIC. 

A diuretic we have explained to be a medicine 
which acts directly on the kidneys, increasing their 
secretion, and consequently the amount of urine which 
is voided. 

They are from various sources, animal and vegetable. 
A combination of the two, of a saline and a vegetable 
substance, to wit, act more promptly than either when 
alone. 

In conformity with this well-ascertained principle, 
the formula which we recommend for this purpose 
comprises one of the salts of potash and the powdered 
leaves of an indigenous plant. 

The preparation should be steeped in boiling water, 
which should be taken while still warm, and in 



THE DIURETIC RECOMMENDED. 779 

abundant quantities. The free use of fluids aids all 
diuretics in their action. 

In cases of gravel, suppression of urine, threatened 
dropsy, etc., such a remedy is of much value, and not 
unfrequently affords prompt relief. 

THE ANTIPERIODIC. 

Whenever a disease repeatedly diminishes or disap- 
pears, and then recurs in one, two, or three days, this 
periodical character of its attacks leads the physician 
to suspect at once the action of swamp-poison, such 
as gives rise to fever and ague. 

The specifics which are used in such cases are called 
antiperiodics, and are almost always derived from the 
bark of the cinchona-tree of Peru, hence often called 
"Peruvian bark." 

There are a large number of chemical preparations 
obtained from cinchona, more or less active in the 
treatment of miasmatic diseases. The most familiar 
is quinine, but the bitterness of its taste, and the un- 
pleasant effect on the head which it exerts, render it 
exceedingly disagreeable to many people. 

Hence we have chosen one of the other preparations 
of the bark, and, by combining it with flavoring mate- 
rials, believe that it will be found of nearly equal value 
in all cases, and much less objectionable on the score 
of taste and after-effects. 



780 STANDARD DOMESTIC REMEDIES. 

THE VERMIFUGE. 

As worms most frequently appear in children, who 
object to taking unpleasant medicines, one of the most 
important qualities of a popular vermifuge must be a 
not unpalatable taste. 

Having this object in view, we have selected a for- 
mula which will be found to combine in a marked 
manner a destructive action on worms with an agree- 
able flavor which will render it easy of administration 
to the most sensitive patient. 

Whenever a medicine of this character is given, it 
should be followed, the second day, by a dose of the 
cathartic mentioned in our list, or some other efficient 
laxative, so as to thoroughly purge the bowels. 

Often parents and nurses imagine that a child has 
worms when none are present, and are astonished after 
administering a vermifuge that no worms are passed. 
"We will give in the appropriate place full directions 
how to form a correct opinion on this topic. 

THE SALVE. 

An application to sores, ulcers, festers, and wounds 
is an essential to every family, and they should take 
care to provide themselves with a good one. 

Our experience has been that there is none superior 
for this purpose to the carbolic acid ointment, pre- 
pared from chemically pure carbolic acid in crystals, 
pure leaf lard, and white wax. The strong, tarry 
odor of carbolic acid, so disagreeable to many people, 



THE SALVE RECOMMENDED. 781 

is almost entirely avoided by the use of a perfectly 
pure article. This has but a feeble smell, and one 
that is far from unpleasant, resembling somewhat the 
faint scent of a geranium leaf. The skill of the 
pharmacist will enable him to conceal even this by 
the use of an appropriate essential oil. 

An ointment prepared in this manner will act most 
favorably on wounds of the surface of the body, either 
in the human species or in the lower animals. It will 
heal old sores, entirely neutralize their foul odors, and 
prevent flies, etc., collecting on galls, etc., in horses 
and cattle. The eminent London veterinary surgeon, 
Dr. Morton, recommends it for this latter purpose 
beyond any other with which he is acquainted. 

OINTMENT FOR THE ITCH. 

The itch is so contagious and so frequent in many 
localities, especially in public and boarding schools, 
that every family should keep on hand an ointment 
which will prove a prompt and effectual remedy as 
soon as the disease manifests itself. 

We have such a one in the preparation recom- 
mended by the distinguished American surgeon, Pro- 
fessor S. D. Gross. It is composed of sulphur and 
nitrate of potash. 

This we recommend prepared in separate papers, one 
of which is to be rubbed up in a tablespoon heaping 
full of fresh pure lard, and the parts anointed with it 
night and morning. The treatment should commence 



782 STANDARD DOMESTIC REMEDIES. 

with a thorough cleansing of the part with strong soft 
soap and water. 



AN ALTERATIVE. 

By this name we mean a medicine which will 
change or alter the functions of the system, without 
direct action on any particular one of them. Such 
remedies are useful in many chronic complaints, where 
the state of ill health seems dependent on a generally 
disordered condition of the functions. 

That drug which is undoubtedly the most efficient 
in this direction is the iodide of potassium. Many 
preparations offered by venders of patent medicines 
depend for their power upon it. 

In the form in which we recommend it, it will be 
found combined with other substances to increase the 
promptness of its action, and to conceal the somewhat 
salty and distasteful character of the crude substance. 




CHAPTER VI. 

ON GENERAL DISEASES. 



CONTENTS. 

The causes of disease — Communicable, infectious, endemic, and hereditary 
affections — Diseases from unknown causes. 

Scrofula. Definition of the disease— Its extent and mortality — The causes 
of scrofula — Is it contagious ? — Is it dangerous ? — How long it lasts — The 
consequences it leaves — How to recognize it — How to treat it: Hygienic 
means of cure ; medicinal means of cure, by home remedies, by drugs and 
standard remedies. 

Scurvy. Its prevalence in former times — The circumstances under which it 
appears — Influence of age and sex ; of previous health ; of weather and 
climate ; of diet — Is it dangerous ? — Its duration — How to tell it — The 
treatment : by diet, by medicines. 

Rheumatism. The two forms of the disease — Rheumatic fever — Circum- 
stances under which it appears — Influence of age, of sex, of previous 
health, of the season of the year, weather and climate, of occupation — Is it 
dangerous? — How long it ordinarily lasts — How to tell it — The treatment: 
by nursing, care of the affected joints, by medicines — Chronic or muscular 
rheumatism — Causes of the disease — Influence of age — Lumbago — Wry- 
neck — Treatment of muscular rheumatism. 

Smallpox. Protection afforded by one attack — Inoculation as a preventive 
— Vaccination — History of its discovery — Circumstances which favor the 
appearance of smallpox — Influence of age, fear, race, contagion — The 
period of the disease when there is the most danger from contagion — The 
mortality of smallpox — Its after-effects — How to recognize the disease — 
The symptoms — The treatment — Diet of the patient — The care of the person 
of the patient — How to relieve the itching — How to prevent pitting — The 
modern treatment — Regulations proper during an epidemic of smallpox — 
Varioloid. 

( 183 ) 




784 ON GENERAL DISEASES. 

Milk Sickness. Its nature— When prevalent— Discovery of the cause of 
the disease — Treatment. 



THE CAUSES OF DISEASE. 

S" commencing this chapter, we will preface it 
with a few words on the Causes of diseases. 
In a general way, this subject has been spoken of in 
the first part of our work, and also referred to on the 
previous pages of the Third Part. 

Communicable diseases are those which are con- 
tracted by the presence of a person who suffers from 
them, such as smallpox, cholera, yellow fever, etc. 
Whether this is owing to infinitely small organic 
bodies — animal or vegetable — which are given off from 
the body of the patient and gain access through the 
lungs to the blood of the healthy bystander, we cannot 
definitely say at present. But the fact cannot be dis- 
puted that such diseases pass from person to person. 

Infectious diseases are those which arise from the 
presence of some poisonous material in the air of a 
locality, which material is not, however, increased and 
disseminated by the human body. Fever and ague, 
remittent fever, and probably typhoid fever, are exam- 
ples of this class of causes. Some emanations from 
swamps, rotting wood, and freshly upturned soil ren- 
der the atmosphere unhealthy, and persons sicken 
without apparent cause or exposure. 

"When this poison is widely distributed, and suffi- 
ciently powerful to affect many, the disease thus 
caused is said to be epidemic; when it is always pre- 



THE CAUSES OF DISEASE. 785 

sent in a locality, but not always so violent as to cause 
an epidemic, it is said to be endemic. 

Besides from actual poisons of this nature, diseases 
arise from disturbance of functions. "When perspira- 
tion is suddenly checked by exposure to a draft of 
cold air, or when the blood is impoverished by an 
absence of proper food, and the necessary physiolo- 
gical changes thus prevented, the part and the whole 
body suffer, and some disease arises. 

An inborn or hereditary tendency to disease is very 
frequently present. This we have discussed so fully 
in our other works, and in the first part of the present 
treatise, that we need not recapitulate here what we 
have there said. 

Often disease arises without known cause. It should 
always be the duty of both attendants and patients to 
ascertain by minute inquiry in such cases the probable 
origin, so that it may be properly guarded against in 
future. 



50 



786 on general diseases. 

Scrofula. 

There is, perhaps, no disease more widely spread 
than this. Families and society at large alike suffer 
from ravages due to the scrofulous taint. 



DEFINITION" OF THE DISEASE. 

The word scrofula is derived from scrofa, meaning 
a sow. The term was originally confined to a swell- 
ing of the glands of the neck, which gave to the jaws 
of the patient the appearance of the pendulent jowls 
of the pig. At present, it has a wider significance. 
It is now applied to a morbid state of the system 
which shows itself in disordered blood, swollen glands, 
running sores, disease of the spine, hips, lungs, eyes, 
and ears. Scrofulous disease of the lungs is known 
as consumption, and will receive our attention when 
we come to treat of diseases of the organs of breath- 
ing. 

ITS EXTENT AND MORTALITY. 

Scrofula is not only wide-spread, but of great mor- 
tality. The diseases to which it gives rise, or with 
which it is intimately associated, are numerous and of 
fatal character. 

It usually appears between the ages of three and 
ten, although it sometimes attacks the infant before 
birth. The disease shows itself in children in the form 
of external scrofula, but after the age of puberty its 



SCROFULA. 787 

most common manifestation is seen in that dreaded 
foe to American life, consumption of the lungs. 

THE CAUSES OF SCROFULA. 

Scrofula is largely hereditary. It is a legacy handed 
down from parents to children. Among the other 
causes which predispose to it are bad air, bad food, 
and a cold, damp atmosphere. "Whenever the taint 
exists in the system, whatever tends to lower the vital 
forces and to injure the general health is calculated 
to call the disease into action. Hence residence in 
the crowded, ill-ventilated, and filthy lanes and streets 
of a great city is a prolific cause of disease. The 
children of the city poor are very generally scrofulous 
on this account, and because of their insufficient and 
unwholesome food, foul clothing, and imperfect shelter 
from cold and moisture. The children of the rich 
suffer almost to an equal extent, because of the un- 
healthy habits, the intemperance, and the vices of their 
parents. Hooping-cough is sometimes followed by 
the development of scrofula. This more frequently 
happens among the weak and badly nourished chil- 
dren of the poor than those in better circumstances. 
Long-continued dyspeptic affections sometimes give 
rise to the disease; so also does the excessive and 
prolonged use of mercury. 



788 ON" GENERAL DISEASES. 

IS SCROFULA CONTAGIOUS? 

On this point there is a difference of opinion in the 
profession. Some recent experiments made in France 
would seem to show that in some cases the disease is 
transmissible from one person to another when they 
live together and breathe the same atmosphere. There 
is little doubt that scrofulous disease of the lungs, 
consumption, is communicated occasionally in this way. 
In most instances, however, scrofula is the result of 
inheritance or developed by defective hygiene. 

IS SCROFULA DANGEROUS ? 

"When scrofula attacks the internal organs, particu- 
larly when it invades the lungs, the fatal character of 
the malady is unfortunately known to every one. The 
external forms of scrofula are more amenable to 
hygienic and medicinal treatment. The disease, when 
it attacks the spine and the hip-joint, often produces 
frightful deformity. Modern surgery has made rapid 
advances in the treatment of spine and hip-joint 
disease. "When seen sufficiently early, the skilful 
surgeon, by means of appropriate apparatus, can save 
not only the life but the symmetry of the patient. 
No parent of a scrofulous child should, therefore, lose 
time in seeking the counsel and personal attendance 
of an experienced surgeon so soon as there is any sign 
of disease of the spine or hip, one of the first symp- 
toms of the latter being persistent pain in the knee. 
If we could impress upon parents the importance of 



SCROFULA. 789 

this advice, there would be fewer cripples in the next 
generation. 

HOW LONG DOES SCROFULA LAST ? 

The duration of the disease varies according to the 
parts affected, the general powers of the system, and 
the nature of the surroundings. External scrofula 
frequently disappears under appropriate management 
during childhood, or, continuing after puberty, is finally 
recovered from in middle life. When the disease 
attacks the lungs, the case ordinarily terminates 
fatally in one or two years ; when the brain is affected 
the patient may die in a few days. 

THE CONSEQUENCES OF THE DISEASE. 

The after-effects of scrofula are often of the saddest 
description. The disease may destroy the structure 
of a joint, and leave the person a cripple for life; it 
may impair the delicate organization of the eye or ear, 
and produce blindness or deafness ; it may eat through 
the bony case of the spinal column, and make a hunch- 
back; it may form ulcers upon the skin, and mark the 
neck or face with ineradicable scars. "We see, there- 
fore, the importance of prevention and of early treat- 
ment in this disease. 

HOW TO RECOGNIZE THE DISEASE. 

Those who are laboring under scrofula, or who have 
a scrofulous constitution, are usually readily distin- 



790 ON GENERAL DISEASES. 

guished by the character of the complexion, the con- 
dition of the blood, and the state of the digestive 
organs. Prof. Gross gives the following graphic 
description of the disease : — 

"The complexion is generally brunette, and the hair, 
for the most part, dark, although in both these re- 
spects the greatest possible diversity exists. The 
eyelashes are drooping and of extraordinary length; 
the pupils are habitually dilated; the upper lip is 
tumid; the face is pale and puffy; the hands and feet 
are nearly always cold; the body is usually impressi- 
ble by atmospheric vicissitudes ; the belly is hard and 
distended; there is a deficiency of muscular strength; 
and the intellect is dull and sluggish, instead of being 
sprightly and precocious, as is usually represented. 
The digestive organs are subject to frequent derange- 
ment; the appetite is irregular and capricious; the 
bowels are either constipated or relaxed, seldom en- 
tirely natural; digestion is feeble and imperfect; great 
annoyance is experienced from flatulence and acidity; 
and the individual is often a martyr to dyspepsia. 
Children predisposed to the disease are particularly 
prone to eruptions about the scalp, to purulent dis- 
charges from the ears, and to chronic enlargement of 
the tonsils. 

" There is another class of scrofulous subjects of a 
state of mind and body almost the opposite of that 
just described. The complexion is light and florid, 
the eye blue, the mind usually active, and the circula- 
tion of the blood on the surface quite vigorous. The 
parts of the body which are the most liable to suffer, 



SCROFULA. 791 

in this form of constitution, are the bones and joints, 
the eye, skin, and glands of the neck, consumption 
being more rare than in the dark variety." 



THE TREATMENT OF SCROFULA. 

We have dwelt at some length, as our reader will 
remember, on the prevention of scrofula (see page 202). 
We shall, therefore, confine our remarks here to those 
means best calculated to combat the inroads of the 
disease when it has already established itself in the 
system. These means are twofold, hygienic and 
medicinal. First, as to the 



HYGIENIC MEANS OF CURE. 

These are all important in this affection. If they 
be neglected, medicine will amount to little. We may 
enumerate them as follows : — 

1. An abundant supply of fresh pure air for breath- 
ing. A change of air is often very beneficial. The 
patient should not, of course, be taken to an unhealthy 
place, nor to one extremely cold or hot. The soil 
should be dry, and the temperature as uniform as 
possible. Scrofula seldom breaks out in the warm, 
dry weather of summer. 

2. A residence by the seaside. The advantage of a 
sojourn at the seaside, and of sea-baths, in cases not 
too far advanced, can scarcely be overestimated. 

3. Exercise in the open air. Patients are ordinarily 
too closely confined to the house in this affection. 



792 ON GENERAL DISEASES. 

They must be encouraged to seek active exercise out 
of doors, and to regard the sedentary pursuits of the 
house as dangerous. 

4. Cleanliness of the person. The skin should 
receive special attention, and be frequently washed 
with salt and water. 

5. Warm clothing. The dress should be such as to 
retain the warmth of the body. Flannel must be worn 
next the skin in all seasons of the year. The feet, 
which are always inclined to be cold in scrofulous 
persons, are to be warmly covered by thick stockings 
and shoes. 

6. Simple hut nutritious food. The diet should 
consist of fats, oils, milk, cream, and both vegetables 
and meat. It should be unirritating and pleasant, and 
not taken in such quantities at one meal as to oppress 
the digestive powers. 

7. Plenty of sleep. The hours of rest should be 
from sunset to sunrise. 

8. A sea-voyage. A long voyage, when the disease 
is not too far advanced, is of incalculable benefit. 

MEDICINAL MEANS OF CURE. 

In connection with the hygienic means of cure we 
have just mentioned, certain drugs have a curative 
agency — in connection with hygienic means we say, 
for the two cannot be separated. Medicine alone will 
cure no case of scrofula. Proper medication will 
hasten the recovery of a patient whose general health 
is at the same time well cared for. The object of 



SCROFULA. 793 

treatment is to improve the nutrition of the body, so 
as to secure healthy blood. To accomplish this, the 
most important step is to enable the patient to take 
and digest as large a quantity as possible of fatty 
matters. A number of 



HOME REMEDIES 

Are useful in this disease. The marrow of bones of 
oxen has been employed with benefit. So also has oil 
from the foot of the young heifer — neafs-foot oil. 
Suet boiled in rice milk (for receipt, see page 499) is 
also a remedy with some reputation. Asses' milk, 
and milk drawn from the cow a short time after the 
greater part of the milk has been withdrawn, when 
freely taken and persevered in, have accomplished 
good results. 

DRUGS AND STANDARD REMEDIES. 

There is no article of greater value than cod-liver oil. 
Those cases are most improved by it where there is 
much emaciation and where the disease has lasted a 
long time. Only the cleanest and most agreeable 
kind of oil should be chosen, and its use is to be 
persevered in for a long while. The dose for children 
is a half teaspoonful three times a day, gradually 
increased to two teaspoonsful thrice daily; for adults, 
a tablespoonful three times a day. The best time for 
its administration is between meals, after the process 
of digestion is pretty well finished. Some prefer to 



794 ON GENERAL DISEASES. 

take it before meals, and thus avoid the disagreeable 
rising of the oil in the mouth; nobody likes it directly 
after meals. 

Various methods of taking cod-liver oil so as to 
disguise the taste have been invented. Some think 
the taste best concealed by taking it floating on the 
top of a glass of ice-water, others in lemon-juice or 
the froth of porter. When it is possible to get soda- 
water, put up in bottles with a siphon for family use, 
the taste may be entirely masked in the following 
manner: Put in the bottom of a tumbler some syrup 
of sarsaparilla (or any other syrup which may be pre- 
ferred, but sarsaparilla best conceals the flavor of the 
oil), fill up with soda-water, and, while still foaming, 
pour a tablespoonful of oil into the centre of the glass, 
and drink at once. 

A piece of lemon-peel or cinnamon, or the chewing 
of a few cloves just before taking the oil, will disguise 
the flavor. Some prefer it beaten up with an equal 
amount of lime-water, or of milk, or with the yelk of 
an egg and a tablespoonful or two of compound tinc- 
ture of cardamoms. 

Or, the oil may be combined in either of the follow- 
ing ways: — 



Take of— 

Cod-liver oil, one fluidounce. 

Peppermint-water, 

Tincture of orange-peel, each half a fluidounce. 

Mixture of gum Arabic, three and a half fluidounces. 

Oil of winter-green, ten drops. Mix. 

A dessertspoonful (two teaspoonsful) three times a 
day, for a child. This receipt will be found to disguise 
the taste of the oil. 



SCROFULA. 795 



Take of— 

Cod-liver oil, one and a half fluidounces. 

Oil of creasote, four drops. 

Powdered tragacanth, 

Powdered gum Arabic, 

Powdered starch, each one scruple. 

White sugar, one drachm. 

Aniseed-water, four and a half fluidounces. Mix. 
Take one or two tablespoonsful three times a day. 
This makes quite a palatable mixture ; the creasote 
in it renders the oil more readily borne by the stomach. 



After the oil has been taken for a while it will not 
be necessary to resort to any means of disguising its 
taste, for it will cease to be disagreeable. "When 
properly given, the cod-liver improves the condition 
of the stomach, increases the flesh and strength of the 
patient, and exerts a remedial influence upon the 
disease. 

"When the oil cannot be well borne by the stomach, 
it may be rubbed in over the belly and chest, and 
applied by means of lint saturated with it. Two 
tablespoonsful may be rubbed in this manner into the 
skin every evening at bedtime. To disguise the dis- 
agreeable smell of the oil, add to every two table- 
spoonsful twenty or thirty drops of the oil of cajeput. 
This method of administering the oil is useful both in 
the cases of children and of delicate adults. 

Next to cod-liver oil, or, perhaps, of equal value 
with it, is iodine. About fifty years ago the virtues of 
this article were first made public by a physician of 
Geneva. Since then it has established itself as a 
most powerful anti-scrofulitic remedy. It is most 
commonly administered in the form of a preparation 



796 



ON GENERAL DISEASES. 



known as LugoFs solution, or in union with iron, as 
the iodide of iron. 

Of Lugol's solution the dose for a child is from two 
to ten drops, for an adult from five to fifteen drops, in 
a wineglassful of sweetened water, three times a day. 

Or, the following formula may be used: — 



Take of— 

Iodine, ten grains. 

Iodide of potassium, twenty grains. 

Water, one fluidounce. Mix. 
Dose, from four to six drops for a child, three times 
a day, in sweetened water ; for an adult double or treble 
this dose. 



The iodide of iron may be given as follows :- 



Take of— 






Iodide of 


iron, four grains. 




Glycerine 


, half a fluidounce. 




Infusion of columbo, two and a 


half fluidounces. 


Mix. 






Give one or 


two teaspoonsful three 


times a day for a 


child. 







An adult may take the iodide of iron in pill form, 
a sugar-coated pill containing one or two grains three 
times in the twenty-four hours. Or the syrup of the 
iodide of iron may be employed in doses of from ten 
to thirty drops. 

The bowels are to be kept in a good condition. 
Active purgatives are not to be used. If necessary, 
the patient may take in the morning a Seidlitz powder, 
or a dose of citrate of magnesia. The bowels should 
be kept in order by attention to diet and exercise 
rather than by medicine. 



SCROFULA. 797 

We have already spoken of the value of natural 
iron or chalybeate waters of some of the mineral 
springs of Virginia, and of the salt lakes of Florida, 
in this affection (pp. 645, 649, 651) ; of the importance 
of a change of climate (p. 655), and how to choose 
one (p. 656) ; and of the use of the black elder (p. 
727), of burdock (p. 728), and of juniper (p. 730). 



798 on general diseases. 

Scurvy. 

This is a disease produced by too long confinement 
to one kind of food, and especially by the prolonged 
deprivation of the juicy vegetables. It is, therefore, 
met with in armies and ship crews, where the diet is 
deficient in variety or of bad quality, and the water 
foul or stagnant. 
♦ 

PREVALENCE OE THE DISEASE IN FORMER TIMES. 

In former times, before its cause and remedy were 
known, the disease carried off, at times, from the armies 
and navies of the world, more men than were killed by 
the enemy. It is mentioned by Pliny as creating 
frightful ravages in the army of Germanicus during 
the long encampment in Germany beyond the Rhine. 
The army of Louis IX. in Egypt, in the year 1260, 
with only fish for fresh provisions, was nearly annihi- 
lated by an outbreak of this affection. The earlier 
navigators suffered severely from it. Thus Yasco de 
Gama, in his first voyage by the Cape of Good Hope 
to the East Indies in 1497, lost, out of a crew of one 
hundred and sixty men, one hundred. James Cartier, 
in his second voyage to New Foundland, in 1535, 
suffered fearfully. He says : " This malady being un- 
known to us, the body of one of our men was opened 
to see if, by any possible means, the occasion of it 
might be discovered, and the rest of us preserved. 
But in such sort did the malady increase, that there 
were not above three sound men left. Twenty-five of 



scurvy. 799 

our best men died; and all the rest were so ill that we 
thought they would never recover again." Admiral 
Hosier, who sailed from England for the "West Indies 
in 1726 with seven ships of the line, twice lost his 
whole crew by scurvy. Anson, in his celebrated ex- 
pedition against the Spaniards in 1740-42, lost within 
the first ten months nearly two-thirds of his crew by 
scurvy, the deaths amounting at one time to four or 
five a day, and during the remaining period of his 
voyage he lost one-half of the survivors. Indeed, it 
has been asserted, on good authority, that prior to the 
nineteenth century more seamen perished from scurvy 
alone than from all other disease, tempest, and battle 
combined. One of the greatest triumphs achieved 
by the celebrated navigator, Captain Cook, was against 
this disease. He returned in 1775 from a three years' 
voyage with a healthy crew, of whom only one out of 
the one hundred and twelve men had died from disease. 
For his important improvements for preserving the 
health of seamen, the Royal Society bestowed on him 
the medal of Sir Godfrey Copley. He is said to have 
given his men, as part of their diet, the following 
articles as preventives against scurvy: sowens, malt, 
sugar, French acid wines, spruce beer, and sour-krout. 
The use of this last article by the Dutch sailor is stated 
as the reason of his very general immunity from the 
disease. 

Dr. Lind, in a work on scurvy published in England 
in 1757, clearly proved the preventive powers of lemons 
and oranges against this disease. But his earnest 
counsels to his government on this point were unheeded 



800 ON GENERAL DISEASES. 

for nearly forty years. In fact, the most conclusive 
evidence in regard to the influence of lemon-juice in 
preventing scurvy was obtained much earlier, but dis- 
regarded. Four ships sailed from England in 1609 for 
the East India Company. One-fourth of the crews of 
three of these ships died from scurvy before they 
arrived at the Cape of Good Hope; the crew of the 
fourth, the commodore's ship, escaped entirely any 
visit from the disease, in consequence of three table- 
spoonsful of lemon-juice having been served daily to 
each of the men. Finally, in consequence of a rep- 
resentation of the medical board of the navy in 1795, 
the English admiralty issued an order for the furnish- 
ing of the fleet with a regular supply of lemon-juice. 
Since then the disease has been gradually becoming 
extinct in the English navy. 

The United States army suffered from scurvy both 
in the Mexican war and during the late civil conflict. 
Dr. Clymer states that, in the column which marched 
on the city of Mexico, the men, for some time previous 
to their landing at Vera Cruz, during the siege, and 
afterwards, could obtain no vegetables. On their 
arrival at Jalapa, although there had been plenty of 
fresh beef, there was scarcely a man who did not have 
a taint of scurvy in his system. Towards the close 
of our civil war the disease appeared in both armies, 
in consequence of a diminished commissariat, increased 
hardships, and the want of fresh vegetables. 



SCURVY. 801 

THE CIRCUMSTANCES UNDER WHICH SCURVY APPEARS. 

Age and Sex. — Scurvy is not often seen in child- 
hood. It appears more frequently among men than 
women, because the former, as soldiers, sailors, and 
travellers, are more frequently exposed to the causes 
of the disease. 

Previous Health. — Those who have previously suf- 
fered from chills and fever are known to be more open 
to scurvy, when exposed to the influences which pro- 
duce it, than those who have never had any malarial 
affection. It was found in the Crimean army that 
scurvy was more prevalent and fatal in those regi- 
ments which had been stationed recently in a malarial 
country. 

Weather and Climate. — It is known that exposure 
to damp and cold favors the development of this affec- 
tion. So also do homesickness, disappointment, and 
depression of spirits. We find, however, the principal, 
and in fact the one essential cause of the disease, in 
the 

Diet. — Every attack of scurvy is preceded and 
induced by a deficiency or ivant of fresh vegetables. 
"With an abundance and variety of vegetables, scurvy 
is impossible. This matter of variety is important. 
Upon no one article of diet, excepting milk, can a man 
live without impoverishing the blood. Monotony and 
restriction in food endanger the health. An exclusive 
diet, even of beef and potatoes, will disorder the blood. 
It is not uncommon to see scurvy among farm-laborers, 
who have been living upon salt meat and few or no 

51 



802 ON GENERAL DISEASES. 

vegetables. The giving of vegetable food, especially 
of the juicy vegetables, is the great preventive and 
counteractive of scurvy. The use of salt, to which 
scurvy is sometimes attributed, has no influence in 
producing it. 

IS SCURVY DANGEROUS ? 

"When proper medical care and diet can be had, 
scurvy is usually readily controlled — recovery taking 
place even when the disease seems very severe. In 
those cases where proper food and medicine cannot 
be had, the malady is very fatal, as is evident from the 
account we have given of its fearful ravages by sea 
and land. 

THE DURATION OF THE DISEASE. 

Scurvy ordinarily lasts a number of weeks. Under 
favorable circumstances it not unfrequently lasts 
many months. Patients recover their health and 
strength slowly. 

HOW TO TELL THE DISEASE. 

One of the first symptoms is a change in the color of 
the skin, especially of the face and eyelids. Black and 
blue looking swellings surround the eyes. At the same 
time, wearying pains are complained of in the bones, 
the muscles are stiff and painful, the spirits depressed, 
and the mind anxious. There is a great longing for 
juicy fruits and fresh vegetables, of which the patient 



SCURVY. 803 

often dreams. The breath becomes offensive, and 
attacks of difficulty of breathing are readily brought 
on by the least exertion. With these symptoms there 
is no fever, the skin being rather cooler than natu- 
ral, and the pulse slow. As the disease advances, 
the countenance gets bloated and yellow or sallow, 
the gums swell and become soft, spongy, and red, 
bleeding upon the slightest touch. In old persons, 
who are toothless, the gums are not affected, but re- 
main healthy all through the disease. Gradually, the 
teeth loosen, the breath becomes more fetid, and the 
tongue white. The patient becomes weaker and 
weaker, bleeding ulcers break out over the body, pro- 
fuse bleeding takes place from the mouth, nose, 
stomach, and bowels, old sores open, and the bond of 
union between the ends of broken bones softens and 
dissolves so that the ends separate. The pulse now 
increases in frequency, beating from 120 to 140 times 
in the minute, the teeth fall out, and the gums fall off 
in shreds, diarrhoea or dropsy appears, and the patient 
dies suddenly, perhaps after having just taken a short 
walk. 

The tendency to faint is very great in severe cases. 
Consequently, a slight motion, suddenly sitting up in 
bed or rising from a chair, may lead to fatal swooning. 
It is said of the ghastly voyage of Lord Anson, of 
which we have spoken, that many of the men, although 
confined to their hammocks, ate and drank heartily, 
were cheerful, and talked with much seeming vigor 
and in a strong tone of voice, yet, on their being the 
least moved, although it was only from one part of the 



804 ON GENERAL DISEASES. 

ship to the other, and that in their hammocks, they 
immediately expired. Some, confiding in their appa- 
rent strength, resolved to get out of their hammocks, 
but died before they reached the deck. Others, able to 
walk the deck, dropped dead on attempting any un- 
usual exertion. 



THE TREATMENT OF SCURVY 

May be briefly stated as follows : keep the patient in 
a pure air; make him warm and comfortable, and give 
him fresh succulent vegetables and juicy fruits. 
Lemon or lime juice is particularly valuable, both as a 
preventive and remedy — it is a specific against the 
disease. Vinegar is also useful, and pickles, sour- 
krout, and salads. Oranges, cocoanuts, and water- 
cresses are all efficient remedies. Among vegetables, 
the potato occupies the first rank; then the onion, 
sliced and eaten raw; cabbage, particularly as sour- 
krout; prickly pear; wild artichoke; green corn; yam; 
sorghum; apples; leeks; garlic; turnips. Besides 
these remedies, new milk and nourishing soups are to 
be given, and, so soon as the condition of the gums 
will permit, fresh or even raw meat. 

Lemons, cut into small pieces and eaten with sugar, 
are very grateful and beneficial to the patient. 

Spruce-beer is an admirable remedy in scurvy, and 
a wholesome, agreeable drink for those exposed to the 
disease. It was used successfully by Captain Cook, 
as we have mentioned, to preserve the health of his 
crew. It is made as follows: — 





SCURVY. 


805 




Select young branches from the Black Spruce Fir 
(Abies nigra), and extract the essence from them by 
boiling down to concentration. Take of this spruce 
essence, a tumblerful (half a pint); bruised allspice 
and ginger, of each four ounces ; water, three gallons. 
Boil for five or ten minutes; then strain, and add 
eleven gallons of warm water, a pint of yeast, and 
six pints of molasses. Mix, and allow the mixture to 
ferment for twenty-four hours. 




Dried or desiccated vegetables are inferior to fresh, 
but useful if properly cooked. Often great benefit is 
derived from drinking the water in which desiccated 
potatoes have been soaked and boiled. This remedy 
was used with success in our last war, when fresh 
vegetables could not be had. Potatoes are best given 
raw, grated, or cooked unpeeled. 

Raw vegetables are often preferred by the scurvy 
patient, and eaten with avidity. 

Lemon-juice, which is almost infallible, is given in 
the amount of one, two, or three wineglassesful in the 
course of the day. If there be diarrhoea, add a few 
drops of laudanum to each dose. 

Another most excellent remedy is nitre (nitrate of 
potash): — 




Take of— 

Nitre, two drachms. 

Vinegar, six fluidounces. Mix. 
This amount to be taken in the twenty-four hours. 




Dr. 
practi 
be ad( 


Parkes, the well-known English author 
cal hygiene, advises that the following me 
)pted in time of war, in prolonged sojoi 


ity on 
asures 
irn on 



806 ON GENERAL DISEASES. 

board ship, or at places where fresh vegetables are 
scarce. 

1. The supply of fresh vegetables is to be increased 
by all means in our power. Even unripe fruits are 
better than none at all, and we must risk a little diar- 
rhoea for the sake of their properties against scurvy. 
In time of war*every vegetable should be used which 
it is safe to use, and when, made into soups all are 
tolerably pleasant to eat. 

2. The supply of dried vegetables, especially pota- 
toes, cabbage, and cauliflowers, turnips, parsnips, etc., 
is perhaps less useful; dried peas and beans are use- 
less. As a matter of precaution, these dry vegetables 
should be issued early in the campaign, but should 
never supersede the fresh vegetables. 

3. Good lemon-juice should be issued daily, two 
tablespoonsful to each man, and it should be seen that 
all take it. 

4. Vinegar, from one to two tablespoonsful daily to 
each man, should be issued with the rations and used 
in the cooking. 

5. Citrate of potash, tartrate of potash, lactate of 
potash, and the malate of potash should be issued in 
bulk, and used as drinks or added to the food. The 
easiest mode of issuing these salts would be to have 
packets containing enough for one mess of twelve 
men, and to instruct the men how important it is to 
place them in the soups or stews. Possibly they 
might be mixed with the salt and used merely as salt. 

In severe cases of the disease the patient must be 
kept constantly lying down; it is dangerous to rise to 



SCURVY. 807 

the erect posture. The use of a water-mattress, if it 
can be obtained, will prevent bed-sores; otherwise, 
employ the cushions we have described in the article 
on the "Furniture of the Sick-room." (Page 430.) 

The patient should be diverted by a cheerful va- 
riety of amusements, and homesickness, when present, 
remedied, if possible, by sending him home. 

As the patient recovers but slowly, and is in more 
or less danger until he is entirely well, great care 
should be exercised in regard to returning to ordinary 
pursuits or assuming any work requiring violent exer- 
tion. It has happened in the navy, that sailors, whom 
the officers of the ship supposed well enough to return 
to duty, have been ordered aloft and fallen dead from 
the rigging. 



808 on general diseases. 

Rheumatism. 

This is a common, painful, and sometimes dangerous 
disease. A knowledge of its nature and treatment is 
interesting and important to the public, because such 
knowledge can be turned to practical account, in 
relieving the intensity of the suffering, in shortening 
the duration of the malady and of the period of con- 
valescence, and in guarding against many of the perils 
of the attack. The disease presents itself in one or 
two forms, either as rheumatic fever, or as chronic or 
muscular rheumatism. There are a number of other 
minute divisions and technical terms adopted by 
physicians to indicate the locality and cause of the 
affection, but for all practical purposes of recognition, 
prevention, and treatment the two divisions we have 
named are sufficient. 

RHEUMATIC FEVER. 

This disease is also known as articular rheumatism, 
from the fact that the articulations or joints are promi- 
nently affected ; and also as acute rheumatism, because 
it has a rapid ■ progress and a comparatively short 
duration. 

In regard to the circumstances under which rheu- 
matic fever attacks a person, age, sex, previous health, 
season of the year, weather, climate, and occupation 
all exert some influence on the liability to the disease. 

A.ge. — Very few children suffer from rheumatism. 
Indeed, early infancy appears to be a safeguard against 



RHEUMATIC FEVER. 809 

this malady so common in later life. A case occurring 
under four years of age is a very rare and exceptional 
one. Not often does it appear before the fifteenth 
year. Young and middle-aged persons are its ordi- 
nary victims, the greatest number of cases occurring 
between fifteen and thirty. In old age it is compara- 
tively unfrequent — although aged persons suffer from 
muscular stiffness and pain. 

Sex. — Men are supposed, from the nature of their 
occupations, to be more liable to rheumatism than 
women. After the change of life, however, women 
are more liable to the disease than men of the same 
age. 

Previous Health. — Those who suffer from general 
debility — a prostration of the physical and nervous 
powers — are, as would naturally be supposed, more 
open to the invasion of the disease than those in 
robust health. Whatever, therefore, tends to depress 
the system, predisposes the person to an attack of 
rheumatic fever. The possession of an hereditary 
taint is also a predisposing cause, for the disease is of 
a distinctly hereditary character. Nearly one-third 
of all the cases admitted into a large London hospital 
were traced, on careful examination, to a family taint. 

Season of the Year, Weather, and Climate. — It is 
not in the coldest seasons and climates that rheuma- 
tism is most prevalent, but where the temperature is 
most changeable, and where the person is most ex- 
posed to the influence of cold and dampness com- 
bined. It is not the amount of cold, but the variable 
character of the weather, that does the harm. It has 



810 ON GENERAL DISEASES. 

been estimated that there are five persons attacked in 
summer to seven in winter. 

Occupation. — Those occupations which expose the 
worker to cold, moist air, and especially those in 
which there are alternations of temperature, are the 
most apt to develop rheumatic disorders. Hence, 
laborers and others who are unable to guard them- 
selves against dampness are more apt to suffer than 
those who have a more sheltered occupation. 

Rheumatic fever is not contagious. 

IS RHEUMATIC FEVER DANGEROUS? 

The danger is not so much from the disease itself as 
from the serious affections of the heart to which it may 
give rise. In those cases which end fatally, the death 
almost always occurs from inflammation of the heart. 
The number of deaths from rheumatic fever scarcely 
exceeds one out of every thousand deaths from all 
other causes. Hence, we see the comparative freedom 
from danger of death in this, one of the most frequent 
of all diseases; in all probability the number of fatal 
terminations hardly exceeds two out of every one 
hundred cases of the disease. It must be remembered, 
however, that many persons who recover from an at- 
tack of rheumatic fever die some months or years after- 
wards from disease of the heart which the rheumatic 
poison has caused. 



RHEUMATIC FEVER. 811 



HOW LONG IT ORDINARILY LASTS. 

The ordinary duration of an attack of rheumatic 
fever, when it is of an uncomplicated character and 
judiciously managed, is from ten to twenty or thirty 
days. In some cases the fever and pain are gone in 
three or four days ; generally, however, the fever lasts 
until the fourteenth day, when the pain in the joints 
begins to go, and by the fourth week the patient is 
well. 

When patients recover with disease of the heart, the 
consequences are long and sad — a future of ill-health, 
palpitation of the heart, shortness of breath on exer- 
tion, and dropsy. 

HOW TO TELL IT. 

Rheumatic fever shows itself by severe inflamma- 
tion of the hands, feet, or the larger joints, as the 
wrists, ankles, knees, elbows, and shoulder-joint. 
One or more of these parts may be affected; the 
patient is feverish and restless; the affected joint or 
joints are swollen, red, painful, and tender. The fever 
sometimes precedes by a day the swelling of the joints; 
often, however, the reverse is the case. Before the 
fever appears, the patient feels "out of sorts," he com- 
plains of chilliness, and looks pale and sallow. This 
chilliness soon passes away, and intense heat of skin 
follows. M"ow the disease may be considered fairly 
established, and the patient presents a pitiable spec- 
tacle. The pain in the joints is so severe, and the 



812 



ON GENERAL DISEASES. 



tenderness so exquisite, that he cannot bear the 
weight of the bedclothes; he is restless, but dare not 
move; the skin is covered entirely or partially by a 
copious, sour perspiration, of an unpleasant smell; the 
tongue is heavily coated; the pulse rapid, full, and 
bounding; and the bowels ordinarily constipated, 
although occasionally there is diarrhoea. 

The pain and inflammation are of a vagabond char- 
acter, particularly at first, wandering about in many 
cases from joint to joint and from limb to limb, until 
it seems that scarcely any part of the body will 
escape its capricious attack. 

At the height of the disorder, as has been aptly 
said, it is difficult to conceive a more complete picture 
of helplessness and suffering than that to which the 
patient is reduced. "A strong and powerful man, 
generally unused to disease, lies on his back motion- 
less, unable to raise his hand to wipe the drops which 
flow fast from his brow, or the discharge which irri- 
tates his nostril. Indeed, he is so helpless that he is 
not only obliged to be fed, but to be assisted at every 
operation of nature. The sweat in which he lies 
drenched seems to bring him no relief; his position 
admits of no change; if he sleeps, his sleep is short, 
and he wakes up with an exacerbation of suffering 
which renders him fretful, impatient, and discontented 
with all around him." Such is the graphic portraiture 
from the pen of Dr. Aitken. 

Eel apses are very common, and as troublesome as 
the original attacks. 



RHEUMATIC FEVER. 813 



THE TEEATMEXT OF EHEUMATIC FEVER. 

Various plans of treatment, and a vast number of 
remedies, have been employed to combat this disease. 
"We shall mention only those now in favor with the 
profession, and which have received the sanction of the 
widest experience and highest authority. Nursing is 
of as much importance to the comfort and safety of 
the patient as medicine. "We shall, therefore, first 
direct 

HOW TO XTJ RSE THE RHEUMATIC PATIEXT. 

The patient should not wear a linen or muslin bed- 
gown. ]STo linen must be allowed to come in contact 
with the skin, even a linen front to the shirt is dan- 
gerous. The undergarment, bed-gown, and dressing- 
gown should be of flannel. 

Particular attention is to be paid to the making 
of the led. All sheets are to be removed, and the 
patient laid between blankets, the newest and fluffiest 
that can be obtained. The head must be carefully 
protected from drafts. 

By clothing the patient in flannel, and placing him 
between blankets, perspiration is promoted, and chills 
prevented. The room should be kept at an even and 
rather warm temperature, and care is to be taken not 
to expose any portion of the patient's person, when 
moist with perspiration, to the air. He is to be sedu- 
lously defended from cold drafts. 

On the first appearance of pain in any joint, it is to 
be well wrapped up in cotton- wool, smoothly adjusted 



814 ON GENERAL DISEASES. 

and firmly secured by a flannel bandage. The cotton- 
wool must be applied smoothly and equally to the sur- 
face of the affected joint. The application will then be 
found to give immediate and great relief to the pain. 
After the suffering joints are thus muffled in cotton- 
wool and flannel, a cradle, such as we have described 
on page 430, is to be placed where the weight of the 
bedclothes is painful. 

i 

HOW TO TREAT THE SWOLLEN JOINTS. 

In many cases, the only local treatment the affected 
joints require is the wrapping of them up in cotton- 
wool and flannel. In our own practice, we ordinarily 
employ no other treatment even in the more severe 
cases. But there are three other methods of treating 
the affected joints frequently resorted to, from each 
of which good results are obtained, namely, applying 
fomentations, painting with tincture of iodine, and 
blistering. 

Fomentations.- — The painful red and swollen parts 
are wrapped in flannels soaked in hot water, or in a hot 
solution of carbonate of soda, made of the strength 
of an ounce of the soda to a pint of water, over which 
flannel cloths laudanum may be freely sprinkled before 
applying. Or, instead of laudanum, the tincture of 
belladonna may be freely applied to the painful joints, 
and covered with wadding, an application which often 
affords immense relief. 

Painting with Tincture of Iodine. — This is strongly 
recommended by Prof. Harvey L. Byrd, of Baltimore. 



RHEUMATIC FEVER. 815 

The tincture of iodine may be applied pure, or diluted 
with an equal amount of spirits of wine (alcohol). It 
is to be put on by means of a camel's-hair pencil once 
or twice a day. 

Blisters. — Small blisters applied over the affected 
joints early in the disease bring great relief to the 
sufferer, and may even cut short the disease. "When 
several joints are complicated at the same time, so 
that three, or four, or five blisters may be employed, 
one over each joint, at the same time, the beneficial 
effects are most striking. 



CURATIVE DRUGS. 

There are a number of modes of medical treatment 
now in use. The principal are by alkalies, by nitre, 
by lemon-juice, and by bromide of ammonium. 

The alkaline treatment, as it is called, consists in the 
administration of bicarbonate of potash or bicarbo- 
nate of soda. The bicarbonate of potash may be ad- 
ministered as follows : — 



Take of— 
Bicarbonate of potash, one ounce. 
Spirits of mindererus, 
Water, of each three ounces. Mix. 



A tablespoonful in water every five hours. If the 
pain be severe, ten grains of Dover's powder may 
be given at night. The joints should be wrapped up, 
and the patient kept between blankets, in the manner 
we have described. 



816 ON GENERAL DISEASES. 

Bicarbonate of soda, in the same amount, may be 
substituted for the potash in the above recipe, or both 
may be combined. 

As the patient gets a little better, the use of an 
alkaline warm bath will be found of much value. It 
is made as follows: — 



Take of— 




Bicarbonate of potash, two pounds. 




Nitre, one pound. 




Dissolve in the warm water for a hath. 


The bath 


should he about 98°. 





The patient should not remain in longer than ten 
minutes daily. 

Treatment by Nitre. — A very pleasant way of ad- 
ministering nitre is by dissolving it in some thin gruel 
in the proportion of two or three drachms to the quart 
of gruel, the whole to be taken during the twenty- 
four hours. Or, two drachms of nitre may be added 
to the prescription of bicarbonate of potash we have 
just given. 

Treatment by Lemon-juice. — Lemon-juice is to be 
given in the dose of two or three tablespoonsful in 
water, three or four times a day. A pleasant and use- 
ful effervescing mixture is made as follows : Dissolve 
a powder of thirty grains of bicarbonate of potash in 
a tumbler one-fourth full of water; add a tablespoon- 
ful of lemon-juice, and take the mixture while effer- 
vescing. Have a number of these thirty-grain powders 
put up at the druggist's, and repeat the dose one hour 
after each meal. 



RHEUMATIC EEYER. 817 

Treatment hy Bromide of Ammonium. — The follow- 
ing recipe is a valuable one : — 



Take of— 

Bromide of ammonium, half an ounce. 

Tincture of orange-peel, half a fluidounce. 

"Water, two and one-half fluidounces. Mix. 
Give a dessertspoonful every three hours, excepting at 
night. 



The syrup of lime (for receipt, see p. 709) is strongly 
recommended on good French authority. Vinegar is 
a domestic remedy, which, in doses of a teaspoonful 
twice a day, has been found of service. 

Of the standard domestic remedies, we recommend 
a dose of " the anodyne" at bedtime, and one of " the 
febrifuge" twice a day. This method of treatment 
will be found both pleasant and efficacious. 

Whichever of these methods of treatment be 
adopted, the closest attention must be paid to the 
directions w^e have just given for nursing the patient, 
and also to the advice on the subject of diet. If these 
counsels be followed, good results will be obtained 
from the use of either of the curative drugs we have 
mentioned; if, on the contrary, they be neglected, no 
drugs w r ill accomplish much. 

HEART COMPLICATIONS. 

"We have spoken of the great danger in this disease, 
the affection of the heart, and have shown how by careful 
nursing it may be avoided. If the patient shows at 
any time in the course of the illness any heart trouble 

52 



818 ON GENERAL DISEASES. 

by complaining of pain in that region and by the coming 
on of attacks of vomiting, instant action is demanded. 
Leeches are at once to be applied over the heart, 
followed by the use of warm flaxseed-meal poultices. 
Lose no time, minutes are now more precious than 
hours in other diseases. Better be needlessly alarmed 
than to be too late. Get the leeches as soon as possi- 
ble, and, in the meantime, cover the heart with a thick, 
warm poultice and avoid exposing the chest to the air. 
As the patient recovers, care must be exercised in 
returning to the ordinary diet. A relapse is often 
brought on by carelessness in this respect. The 
patient should take less meat than his feelings prompt 
him to swallow. Vegetable matter does not expose 
him to the same risks, he may therefore take freely of 
rice puddings, gruel, porridge, bread, mashed potatoes, 
and other like articles. 



CHRONIC OR MUSCULAR RHEUMATISM. 

Muscular or chronic rheumatism often follows an 
attack of rheumatic fever. The patient gets well of 
the fever and swollen joints, but soreness and stiffness 
of some of the muscles of the body remain to plague 
him for weeks or months. More commonly, however, 
muscular rheumatism comes on as a separate affection 
without having been preceded by rheumatic fever. 

Age is one of the favoring circumstances for its 
development. There are few elderly persons who have 
not more or less acquaintance with this troublesome 
ailment. Cold, damp seasons of the year expose 



MUSCULAR RHEUMATISM. 



819 



persons to the clanger of an attack. Hence the im- 
portance, especially for the aged, to carefully protect 
the skin during inclement weather. 

In this disease there is usually little direct disturb- 
ance of the general health. The patient has no fever, 
but is restless and uncomfortable on account of the 
pain, which is aggravated by every motion. Ordi- 
narily, the warmth of the bed affords relief, and the 
greatest suffering is experienced while the patient is 
up and dressed. 

Muscular rheumatism is known under different 
names according to the parts affected. Thus when 
the muscles of the lower part of the back are the ones 
attacked, the disease is known as lumbago. Every 
motion of the back, particularly the act of stooping, 
is attended with pain in the fleshy muscles on one or 
both sides of the loins. When the muscles of the 
side of the neck are affected, the disease is then 
known as stiff or wryneck. It is commonly caused by 
sitting in a draft. To afford himself relief, the patient 
naturally carries his head bent over to the affected 
side, and any attempt at righting it occasions a sharp 
twinge of pain. When the muscles of the side of the 
chest, between the ribs, are affected, we have the 
disease known under the learned name of pleurodynia, 
which when translated into common English is, pain 
in the side. The "stitch" in the side which is due to 
rheumatism is often mistaken for pleurisy. The 
patient on taking a long breath feels a sharp pain 
between the ribs, which he attributes to disease within 



820 OX GENERAL DISEASES. 

the chest, instead of on the chest walls. Useless 
alarm is thus sometimes excited. 



TREATMENT OF MUSCULAR RHEUMATISM. 

The first requisite is to keep the affected parts 
warm. Thus, in lumbago several folds of warm flannel 
should be constantly worn over the loins, or a warming 
plaster should be applied. Brisk friction twice a day 
with coarse flannel and one of the stimulating lini- 
ments mentioned on page 529 will be found useful. 
Internally, one of the best remedies is iodide of potas- 
sium. It may be administered in the following 
formula: — 



Take of— 

Iodide of potassium, four scruples. 
Huxham's tincture ot bark, 
Water, of each two fluidounces. Mix. 
Take a dessertspoonful in water, three times a day, 

after meals. 



The bark in this prescription will prove beneficial 
by its tonic action. - 

Sleeping between blankets is both comfortable and 
useful to the rheumatic patient. 

Sulphur, salt, and other natural mineral springs are 
of great service in many long-standing cases (see pp. 
648, 651, and 652) ; so also are artificial sulphur-baths 
(see pp. 466, 716), and electricity (see p. 679). 

Rubbing of the affected muscles with coal oil will 
sometimes greatly relieve the pain. 

The American poplar (p. 726), horseradish (p. 740), 



MUSCULAR RHEUMATISM. 821 

and Virginia snakeroot (p. 746), are domestic plants 
which possess anti-rhenmatic virtues. 

Excellent results will be obtained in muscular rheu- 
matism by administering "the anodyne" of the stand- 
ard domestic remedy list (p. 767) at bedtime, and 
taking "the alterative" three times a day. 



822 OX GENERAL DISEASES. 



Smallpox. 



This is, in many respects, a very remarkable dis- 
ease — remarkable from the ravages it has committed 
from time to time in the world's history, and from 
the fact that it is one of those few affections for which 
we now know an absolute preventive in the kindly 
influence of vaccination, which has been justly termed 
"the most valuable among the generous benefits con- 
ferred upon their fellow-men by the cultivators of the 
divine art of healing." 

PROTECTION - AFFORDED BY ONE ATTACK. 

The contagion of smallpox is one of the most 
powerful and certain known. As a general rule, it 
may be stated that one attack exhausts the capacity of 
the system to acquire the disease again at any future 
time. "We know there are many who will call in 
question the truth of this assertion, and point to those 
who, to their own knowledge, have had the disease 
more than once. "We answer that this law is subject 
to very few exceptions indeed, and that most of the 
cases of so-called second attacks will not bear careful 
investigation. A great sensation was occasioned in 
France, in 1774, by the death of Louis XV. from 
smallpox at the age of 64; it having been generally 
believed he had had the disease when he was 14 years 
of age. But Dr. Gregory, who carefully inquired 
into all the circumstances, was convinced that his 
majesty never had the disease in early life. What 



SMALLPOX. 823 

was supposed to have been an attack of smallpox was 
really chicken-pox. The same mistake has been, and 
is constantly being made, in reference to other persons. 
In this way we can account for most of the alleged 
cases in which the affection has reappeared in the 
same individual. This well-authenticated fact of the 
non-liability of an individual who has once passed 
through an attack of smallpox to suffer another attack 
from it, led in former times to the practice of inocula- 
tion. 

INOCULATION AS A PREVENTIVE OF SMALLPOX. 

Inoculation consists in artificially communicating 
the disease by introducing the virus of smallpox, 
obtained from the pustules of a patient laboring under 
it, into the economy by means of a puncture or scratch 
made in the skin. It was found that the disease so 
received was milder than that acquired in the natural 
way, and that it protected the individual forever after. 
It enabled the patient to prepare his system for the 
disease, and to select his own time to have it. All 
these advantages were very great ones, and led to 
the gradual introduction of inoculation, which was 
in more or less general use until the great discovery 
of vaccination supplied a safer, surer, and pleasanter 
means of protection. 

"When and where inoculation was first practised 
is unknown. For many centuries the Chinese claim 
that they practised a method known as " sowing" or 
disseminating the disease by placing the scales of the 



824 ON GENERAL DISEASES. 

eruption in the nostrils of healthy persons. Prom 
time immemorial, a tribe of the Brahmins in Hindos- 
tan engrafted the virus as a religious ceremony. A 
piece of cotton was soaked in the virus and then 
applied to a freshly made wound. The aid of the 
goddess of spots was evoked in behalf of the person 
making the sacrifice — this divinity having first hinted 
at inoculation, they alleged, for "the thought was 
much above the reach of human wisdom and fore- 
sight." It is known that the method of inoculation 
was practised in Turkey in the beginning of the last 
century, and probably much earlier. It was in this 
country that the distinguished Lady Mary Wortley 
Montagu, the wife of the English ambassador at the 
Ottoman court, learned the beneficial results of the 
practice, which she had the courage to introduce 
into England. She writes, in one of her entertaining 
letters, from Adrianople, in the year 1718: "The 
smallpox, so fatal and so general amongst us, is here 
entirely harmless by the invention of engrafting, 
which is the term they give it. Every year thousands 
undergo the operation ; and the French ambassador 
says pleasantly, that they take the smallpox here by 
way of diversion, as they take the waters in other 
countries. There is no example of any one who has 
died of it ; and you may well believe that I am well 
satisfied of the safety of this experiment, since I 
intend to try it on my dear little son. I am patriot 
enough to take pains to bring this useful invention 
into fashion in England." This in fact she did. The 
first person inoculated in England, and probably in 



SMALLPOX. 825 

Europe, was her daughter, upon whom the operation 
was performed in 1721. On the 11th of May follow- 
ing, a son of Dr. Keith, a physician who had visited 
Miss "Wortley, was successfully inoculated. The 
Princess Caroline of Wales, who had nearly lost one 
of her daughters, Princess Ann, by smallpox, took 
great interest in this new operation, and was very 
solicitous to protect her other children by this means. 
In order that she might further satisfy herself of its 
safety and utility, she obtained from the king, her 
father, the pardon of six criminals, condemned to 
death at Newgate, on condition that they should 
submit to inoculation. The operation upon them all 
was performed in August of the same year. They all 
made a good recovery, and thus escaped the halter. 
One of them had the address to conceal that he had 
previously had the disease. The experiment was 
again safely tried upon a female convict, and after- 
wards upon five or six charity children. The princess 
now consulted the court physician, the celebrated Sir 
Hans Sloane, respecting the propriety and safety of 
inoculating her children. Sir Hans being cautious in 
his reply, the princess inquired if it was his desire 
to dissuade her from it, and, being answered in the 
negative, she said, "then I am resolved it shall be 
done," and directed Sir Hans to wait on the king, 
George the First. His majesty readily concurring, 
the Princesses Amelia and Caroline were inoculated 
in April, 1722. In the year 1724 inoculation was a 
second time introduced into the royal family. His 
Royal Highness Prince Frederick, aged 18 years, was 



826 OJST GENERAL DISEASES. 

inoculated at the court of Hanover, and his Boyal 
Highness Prince William was inoculated in London, 
both under the direction of the court physician. 
Each of the princes went through the disease in the 
mildest manner, Prince Frederick not having more 
than eleven or twelve pustules. In the years 1721 
and 1722, 182 persons were inoculated in England; 
in 1723, 292 persons. 

The practice of inoculation was at first much 
opposed, and for a long time Lady Montagu enjoyed 
the privilege of being the best abused person in Eng- 
land. Nor was the opposition confined to the ignorant. 
Physicians and divines joined in the outcry against it. 
Thus Dr. "Wagstaffe, a man of high medical standing, 
remarked, "that posterity will scarcely be brought to 
believe that an experiment, practised only by a few 
ignorant women, should so far obtain in one of the 
politest nations in the world, as to be received into the 
royal palace." Sermons were preached against "the 
dangerous and sinful practice of inoculation." 

Inoculation was introduced in this country in the 
year 1721. The learned Dr. Cotton Mather, of Boston, 
having observed in the Philosophical Transactions, 
printed in London, an account of the operation in 
Turkey, communicated the information to several 
physicians in Boston, who treated the subject with 
contempt. He then recommended his friend, Dr. 
Boylston, of that city, to adopt the practice. Accord- 
ingly,, with the little information he could obtain from 
that publication, and in the face of the most violent 
opposition, Dr. Boylston inoculated, on the 27th day of 



SMALLPOX. 827 

June, 1721, first his only son, about thirteen years of 
age, and then two negro servants. He was completely 
successful in all three cases, thus confirming in his 
own mind his convictions on the subject, and quieting 
to some extent the fears of others. In the years 1721 
and 1722 Dr. Boylston and others inoculated several 
hundred persons. The degree of odium and persecu- 
tion which he brought upon himself by this very 
laudable innovation is almost incredible. He and his 
family were attacked and execrated in the street and 
in his own house. Many sober-minded pious people 
were deliberately of opinion, when he commenced the 
practice of inoculation, that if any of his patients 
should die, he ought to be capitally punished. A bill 
was brought into the legislature for prohibiting the 
practice under severe penalties, and it actually passed 
the house of representatives ; but some doubts existing 
in the council, its progress was arrested, and it never 
became a law. The clergymen in general, however, 
acted an honorable part, and many of them became 
zealous advocates of the new practice. The practice 
of inoculation gradually gained ground, and became 
general in New England. In a few years it was 
extended to New York, Philadelphia, and Charleston. 
By the invitation of Sir Hans Sloane, Dr. Boylston 
visited London, where he was well received, elected a 
member of the Royal Society, and introduced into the 
presence of the royal family. 

The efficacy of inoculation in preserving life and 
preventing deformities was very great. The annual 
number of deaths in the Inoculation Hospital of 



828 ON GENERAL DISEASES. 

London was only three in a thousand; deaths from 
natural smallpox, in unprotected persons, average one 
in three. 

But, notwithstanding the beneficial results from 
inoculation, we have now a much superior expedient 
in vaccination. This renders a resort to inoculation 
unnecessary, and, save in exceptional cases, unjustifi- 
able. When, however, no vaccine matter is to be had, 
and a person is or has recently been exposed to small- 
pox, inoculation may be proper and prudent, in order 
that the inoculated and milder form of the disease may 
get the start of the natural and severer form. A 
remarkable instance in illustration of this statement 
is related by Professor Gregory, who had it from a 
naval surgeon. The smallpox was introduced among 
the crew of a man-of-war in a tropical climate where 
no vaccine matter was to be had. Most of the men 
were unprotected by vaccination. Of sixteen who 
took the disease in the natural way, nine, or over one- 
half, died. Three hundred and sixty-three were at 
once inoculated. Of these not one perished, although 
the operation was performed under all the disadvan- 
tages of a hot climate and want of time to prepare the 
systems of the patients. 

THE DISCOVERT OF VACCINATION. 

About three-quarters of a century ago, Dr. Jenner 
made the most interesting discovery in the whole his- 
tory of medicine — that the eruptive disease which had 
long been observed as occurring on the udders and teats 



SMALLPOX. 829 

of the cow (which he named the cow-pox) was directly 
communicable to the human system, and possessed the 
power of protecting man from the terrible and fatal 
pestilence of smallpox. A popular belief was preva- 
lent upon the dairy farms of Gloucestershire, Eng- 
land, that no person who had had the cow-pox could 
afterwards take the smallpox. Dr. Jenner convinced 
himself, by inoculating with smallpox matter a number 
of individuals who had had cow-pox, that this popular 
notion was not without truth. He continued his ex- 
periments and investigations, and at last conceived 
the happy idea of propagating the cow-pox from one 
person to another. He thus hoped to finally expel 
from the world the disfiguring and dangerous malady, 
smallpox. 

The 14th day of May, 1796, was the birthday of vac- 
cination. "On that day, matter was taken from the 
hand of Sarah Nelmes, who had been infected by her 
master's cows, and inserted by two superficial incisions 
into the arms of James Phipps, a healthy boy of about 
eight years of age. He went through the disease ap- 
parently in a regular and satisfactory manner ; but the 
most agitating part of the trial still remained to be 
performed. It was needful to ascertain whether he 
was secure from the contagion of smallpox. This 
point, so full of anxiety to Dr. Jenner, was fairly put 
to issue on the first of the following July. Variolous 
matter, immediately taken from a pustule, was carefully 
inserted by several incisions, but no disease followed." 

This glorious discovery was announced to the world 
in June, 1798, in a pamphlet published by Dr. Jenner. 



830 ON GENERAL DISEASES. 

He had an almost holy reliance in the truth of his 
investigations, which, he states, he was " encouraged" 
to prosecute " by the hope of their becoming benefi- 
cial to mankind. Many objections were, of course, 
urged against the practice. Some of them were merely 
foolish — as, that it was unnatural and impious to en- 
graft the diseases of a brute upon a Christian. Others 
were untrue — as, that it introduced into the system 
new, unheard-of, and monstrous disorders distinct 
from the cow-pox itself. It triumphed over all these 
evils; and in six years from its first promulgation the 
discovery was known in every region of the world." 

In this country, the discovery was announced in our 
newspapers, and the Medical Repository of New York, 
in the year 1799. Dr. Benjamin Waterhouse, profes- 
sor of medicine in the University at Cambridge, vacci- 
nated in July, 1800, four of his own children, the 
eldest about seven years of age, who thus became the 
first subjects of vaccination in the United States. 
Committees were subsequently appointed to collect 
evidence in regard to the efficiency of cow-pox as a 
preventive of smallpox, and to report the most eligible 
method of conducting the practice. In a short time 
the triumph of vaccination over the most dreaded 
scourge of the human race became established in both 
the professional and public mind. 

For directions in regard to the manner of vaccinat- 
ing, and information as to the necessity for revaccina- 
tion, we refer our readers back to page 242. 

By means of vaccination, not only have the lives of 
many thousands been preserved, but also their good 



SMALLPOX. 831 

looks. Historical records, and many portraits of the 
last portion of the seventeenth and the beginning of 
the eighteenth centuries, show the fearful ravages com- 
mitted by the smallpox upon the population. It would 
seem indeed as if every man had been speckled more or 
less with " pock holes," and the community must have 
presented one moving mass of pits and scars. 

VACCINATION AFTER SMALLPOX. 

We have spoken on page 244 of the importance of 
revaccination. Some physicians have urged that even 
those who have had smallpox should be vaccinated; 
for, although the occurrence of an attack of varioloid 
in a patient who has once had natural smallpox is very 
rare, yet when it does happen the attack may be a 
severe one. From this danger he is protected by 
vaccination. Prof. "Wood, in his work on Practice of 
Medicine, says: "It maybe asked whether vaccination 
should be employed in persons previously affected with 
smallpox. I should unhesitatingly answer this ques- 
tion in the affirmative. It has been before stated 
that, though fewer persons are attacked with varioloid 
after inoculation or natural smallpox than after vacci- 
nation, yet a greater number perish. The same pro- 
tection that a second vaccination extends in one case 
will probably be extended by vaccination in the other, 
and is even more needed, at least so far as life is con- 
cerned. It is generally stated in the books that vacci- 
nation after smallpox produces little or no effect. My 
own observation has been exactly the reverse. In 



832 ON GENERAL DISEASES. 

concluding this subject, I would again strongly urge 
the propriety of universal revaccination, as the means 
not only of promoting the comfort and possibly of 
saving the life of the individual, but also of prevent- 
ing the spread of smallpox and of ultimately eradicat- 
ing it, if not from the globe, at least from extensive 
communities." 

We have, however, said quite sufficient to show the 
importance of vaccination. Having laid before the 
reader these facts in regard to the prevention of the 
disease, we proceed now to give him some information 
in regard to the disease itself, although, if he properly 
heed our advice, he will never suffer from it. 

CIRCUMSTANCES WHICH FAVOR THE APPEARANCE OF 

SMALLPOX. 

Age exerts an influence upon the liability to an 
attack. Children are more susceptible to the disease, 
if unprotected by vaccination, than adults. Fear of 
the disease predisposes the person to an attack. The 
effects of fear are quite marked during an epidemic of 
the disease. Those who are timid and anxious will, 
all other things being equal, be more frequently found 
among the victims of the malady than those who are 
calm and self-possessed. The negro and dark races 
are more prone to the invasion of smallpox than the 
white races. It is also more fatal among negroes than 
whites. The main cause of smallpox, however, is 
contagion ; it passes from person to person, and is thus 
propagated and perpetuated in the community. An 



SMALLPOX. 



833 



obscurity hangs over the origin or first cause of small- 
pox like that which baffles all attempts to arrive at 
the causes which first gave rise to measles and scarlet 
fever. At the present time there is every probability 
that these diseases have no other mode of origin than 
communication from one person to another. There are 
some who believe that smallpox, like a number of 
other maladies, came originally from the lower animals, 
who imparted it to human beings. It is well known 
to those acquainted with the diseases of sheep that 
they are subject to a distemper of the nature of small- 
pox. 

The poisonous material which conveys the disease 
is given out from the breath and skin of the patient, 
from his excretions, from the contents of the blisters 
and sores on his person, and from the scabs. These 
all contain the specific poison, which may attach itself 
to the bed and body clothes, particularly if they he of 
wool, cotton, or felt. Woollen, cotton, or felt stuffs not 
only easily take up the poison, but they retain it for a 
long time — indeed for very many years. 



AT WHAT PERIOD OF THE DISEASE IS THERE THE 
MOST DANGER FROM CONTAGION? 



The poison begins to develop itself in the patient's 
system, and to rapidly multiply itself, during the 
primary fever. It is most powerful, and therefore 
the most dangerous to others, when it is most obvious 
to the sense of smell, that is, after the eruption has 
appeared. No person who has not been vaccinated, 

53 



834 ON GENERAL DISEASES. 

or who has not had the smallpox, should be allowed to 
remain in the same room, or in the same house, with a 
patient affected with the disease. As it has been 
caught by passing a child ill of it in the street, the 
taking of a person affected with it into the public 
highway is an unpardonable procedure on the part of 
those haying him in charge. There is no contagion 
so strong as that of smallpox, and none that acts at 
so great a distance. Even those who have died of the 
disease continue to communicate it long after death. 
In this way the disease has not unfrequently been 
introduced into dissecting-rooms, the infection being 
communicated to those students who have not actually 
touched the corpse, but been merely in its neighbor- 
hood. 



IS THE DISEASE DANGEROUS? 

Fully formed confluent smallpox is a very fatal 
disease. About one person out of every three at- 
tacked fails to recover. Distinct smallpox, as it is 
called, in which the sores are separate and do not run 
into each other, is not so fatal as the confluent form ; 
but the deaths average one in ten of all attacked. In 
varioloid, that modified form of smallpox which affects 
those who have been once vaccinated, but who are not 
entirely protected in consequence of not having been 
re- vaccinated, only about one or two in the hundred 
die. 

The greatest number of deaths from smallpox occurs 
among children. It has been ascertained that out of 



SMALLPOX. 835 

every one hundred deaths from smallpox, seventy-five 
occurred in those below the age of five. 

In pregnant women the disease is particularly 
dangerous. It almost always brings on abortion. 
The foetus which has thus miscarried is in many 
cases marked upon the skin with the disease. 

THE AFTER-EFFECTS OF SMALLPOX. 

It has been observed that scrofula and consumption 
are apt to follow the disease, even in those cases 
which have not been specially severe. Blindness and 
a permanent discharge from the eyes are not unfre- 
quent results. . The voice is sometimes very much 
altered, being rendered disagreeable by injury done 
by the disease to the soft palate. 

Chronic diarrhoea and dropsy, as well as deformities 
of various organs, are among the to-be-dreaded lega- 
cies of smallpox. 

HOW TO RECOGNIZE SMALLPOX. 

"When the disease is fully formed, it is difficult to 
mistake it for any other complaint. But it is impor- 
tant, for many reasons, to be able to tell it as early as 
possible in the attack. The disease sets in w T ith a 
brisk fever; chills, followed by heat and dryness of 
skin; pain in the stomach; nausea, vomiting, and 
headache. But these symptoms are very similar to 
those which usher in a number of other diseases. If 
they show themselves in a person who is unprotected 



836 ON GENERAL DISEASES. 

by vaccination or a previous attack of the disease, 
who lives in a neighborhood where the disease is pre- 
valent, and who, in particular, is known to have been 
especially exposed to the contagion within ten days or 
a fortnight, then there is good reason to suspect that 
these symptoms are the forerunners of smallpox, and 
to act accordingly. 

Besides these early symptoms, there are others 
usually present in smallpox, but which are not com- 
mon in the early stages of other diseases. Vomiting 
is one of these. Pain in the back is another. When 
these symptoms are very violent, they usually intro- 
duce a severe form of the disease. The pain in the 
back is in the centre. It is a sjpine-ache, and not 
affected by any change of posture; in which respect 
it differs from lumbago, which, as we have pointed out 
in treating of rheumatism, is always aggravated by 
motion. The eruption makes its appearance on the 
third or fourth day, first on the lips and forehead. On 
the appearance of the eruption, the fever and muscular 
pain are relieved. 

The diseases with which it is most apt to be con- 
founded are scarlet fever, measles, and chicken-pox. 
The pain in the back is not one of the symptoms in 
these affections, and in neither of them is the fever 
lessened on the appearance of the eruption. Again, the 
eruption first shows itself, in smallpox, on the lips and 
forehead; in scarlet fever, first on the neck and chest; 
in measles, first on the face; in chicken-pox, first on 
the shoulders and back, afterwards on the scalp, and 
often spares the face altogether. The character of the 



SMALLPOX. 837 

eruption varies in each of these diseases. In scarlet 
fever, the whole skin is uniformly red, or the redness 
appears in large patches, with, perhaps, a few raised 
spots and blisters. In measles, the eruption appears 
in crescentic patches, with spaces of healthy skin be- 
tween. In chicken-pox, the eruption appears and dis- 
appears in successive crops, and the disease usually 
runs its course in five or six days, with comparatively 
little fever. 

THE SYMPTOMS OF SMALLPOX. 

After the fever, pain in the back, nausea, vomiting, 
and headache, which we have described as ushering in 
the disease, the eruption makes its appearance on the 
third or fourth day. Sometimes there are also thus 
early in the disease, soreness of the throat, cough, 
pain in the side, and shortness of breath. In children, 
it is not unusual to meet with convulsions or fits. The 
eruption first appears as small red pimples. These 
pimples, in the course of about a week, inflame, and 
matter forms in them. 

The pimples first show themselves on the lips and 
forehead, then on the face, neck, and wrists. They 
next appear on the trunk of the body, and finally on 
the lower extremities. These pimples begin to soften 
and are converted into pustules by the ninth day. 
The pustules then break, and crusts or scabs form. 
In about four or five days more these scabs begin to 
fall off. 

The manner in which this eruption appears and its 



838 ON GENERAL DISEASES. 

amount determine the severity of the disease. Small- 
pox is divided into confluent smallpox and distinct 
smallpox by the nature of the eruption. "When the 
pimples and pustules are not numerous, they remain 
distinct and separate from each other ; hence the dis- 
ease is known as distinct smallpox. When the erup- 
tion is very profuse, the pustules, being close together, 
run into each other and form large blotches ; hence 
the disease is known as confluent smallpox. The 
former is much less dangerous than the latter variety 
of the affection. The term malignant smallpox is ap- 
plied to very bad forms of the confluent disease. It 
is almost uniformly fatal. 

In distinct smallpox, the secondary fever, which sets 
in about the eleventh day of the disease, and the eighth 
day of the eruption, is ordinarily quite mild. In 
confluent smallpox, on the contrary, it is very severe 
and perilous. It occasionally at once proves fatal, 
overwhelming the system, as it were, by the force and 
virulence of the seizure. During its continuance, 
swelling of different glands, destructive inflammation 
of the eyes and ears, and severe diseases of the throat 
and lungs, may make their appearance, so that if the 
unhappy patient escapes with his life, he may find 
himself lame, blind, or deaf. 



TREATMENT OP SMALLPOX. 

As a rule, but few drugs are needed in this disease. 
None of them shorten its duration nor exert any bene- 
ficial influence upon the eruption. Good nursing and 



SMALLPOX. 839 

dietetic management can accomplish all that can be 
done. 

In the first place, the object of the sanitary treat- 
ment is to prevent a copious eruption. As we have 
just had occasion to mention, the severity and danger 
of the attack are in direct proportion to the amount of 
the eruption. We know that there is a popular belief 
about an eruption being " better out than in." This 
is not true of smallpox. In the second place, the 
strength of the patient should be carefully preserved 
and supported. In the third place, when any particu- 
lar organ is attacked, as, for instance, the eye or ear, 
instant attention must be directed towards its defence 
by the most approved methods of treatment. 

DIET OF THE PATIENT. 

This should consist of light nutritious articles, such 
as sago, arrowroot, gruel, weak beef-tea, and other 
like preparations, for which we have given the receipts 
in our chapter -on Cookery for the Sick. Ripe fruits, 
iced lemonade, iced water, cold barley-water, tamarind- 
water, raspberry-vinegar, and water and broken ice, 
may all be freely allowed. The principal thing to 
guard against in the diet of the patient is to prevent 
his being dosed with heating drinks, which are apt to 
be urged by officious, ignorant friends for the purpose 
of bringing out the eruption. 



840 ON GENERAL DISEASES. 

THE CARE OE THE PERSON OF THE PATIENT. 

When the skin is much heated, sponging of the sur- 
face of the body with warm water will be found very 
refreshing, particularly if followed by a change of 
linen. The sick-chamber should be cool and well 
ventilated. The bedclothes should be light and fre- 
quently changed. When the patient is long confined 
to the bed, his back should be frequently examined, in 
order to prevent the formation of ugly sores. If the 
scalp be full of pustules, the hair must be cut off to 
prevent its matting. Indeed, it is good practice, if the 
disease be recognized early enough, to shave the scalp. 
Cold may then be applied to the head more readily, if 
required. 

ATTENTION TO THE BOWELS. 

If the bowels be confined, they must be daily attended 
to. If necessary, a dose of castor oil or a bottle of 
citrate of magnesia may be given. The object is to 
keep the bowels gently open by the use of a little 
laxative food or medicine. 

TO RELIEVE ITCHING. 

The intolerable itching of the skin may be relieved 
by smearing over it some cold cream or some pure 
glycerine, or a mixture of equal parts of sweet oil and 
lime-water, by means of a camel's-hair brush. When 
the pustules have burst, the application of a dry 



SMALLPOX. 841 

powder, such as powdered starch or the oxide of zinc, 
is frequently made to absorb the matter. 



THE SECONDARY FEVER, 

Which comes on about the eighth day of the eruption, 
or the eleventh of the disease, is to be treated bv 
keeping the bowels gently open, and by supporting 
the system by a generous but digestible diet — such as 
strong beef-tea, good soup, animal broths, milk and 
cream, and soft-boiled eggs. 



TO PREVENT PITTING. 

To preserve the face from the unseemly scars of 
smallpox, has been an object long diligently pursued 
by physiologists and physicians. The milder the dis- 
ease, of course, the easier is this task. The more 
severe the eruption, the more difficult it becomes. 

It has been stated that the contact of the atmos- 
pheric air is the cause of the pitting, and that, when 
it is effectually excluded, there is no danger of a scar. 
Consequently, many applications have been suggested 
with this object in view. The various means which 
are employed by different physicians to prevent pitting 
may be enumerated as follows: — 

1. To open each individual pimple after it has begun 
to soften. 

2. To rub on it, after it has softened and become 
a pustule, a piece of lunar caustic (nitrate of silver). 

3. To employ both methods ; that is, to open each 



842 ON GENERAL DISEASES. 

of the little blisters, and pour a strong solution of 
nitrate of silver (five or ten grains to the ounce) into 
the cavity of each. This operation should, to be effec- 
tive, be only employed on the second or third day of 
the eruption. At the end of a week, it is alleged, 
scales fall off, and no pit is left. Some, instead of 
these expedients, paint the whole face with a very 
strong solution of nitrate of silver, one drachm to the 
ounce of water. 

4. To apply a mercurial plaster, which, at the Chil- 
dren's Hospital in Paris, is made by mixing twenty- 
five parts of blue ointment with ten parts of yellow 
wax and six parts of black pitch. This plaster should 
be cut into pieces to fit the different parts of the face, 
one for the cheeks, one for the sides and back of the 
nose, one for the forehead, and others for the upper 
and lower lips. 

5. To apply blue ointment directly, either pure or 
rubbed down with an equal amount of lard. This 
ointment is spread upon a piece of thick muslin, which 
is then cut into the shape of a mask, with holes for 
the eyes, nose, and mouth. It is fastened in its place 
by means of pieces of tape sewn around the edges, 
which are tied behind the head and neck. It is very 
important that the ointment should be kept in constant 
close contact with every part of the face. To accom- 
plish this, a separate piece is used for the nose, which 
is the feature the most difficult to fit. As a rule, four 
or five days are long enough to keep on this mask. 

6. To apply sulphur ointment several times a day. 



SMALLPOX. 843 

7. To apply an ointment of calamine and sweet oil, 
which is made as follows: — 



Take of— 

Common calamine, three parts. 

Oxide of zinc, one part. Mix. 
Eub in a mortar with sufficient sweet oil to form a 
thick adhesive crust when applied to the skin. 



This application is to be preferred to that of the 
mercurial plasters or ointment, because there is no 
danger of salivation; and to the use of nitrate of 
silver, because of the pain of the latter. 

8. To apply tincture of iodine by means of a brush. 

9. To apply a saturated solution of gutta-percha in 
chloroform (Liquor gutta-percha). This application 
is especially serviceable, as it completely excludes the 
air. It is to be put on as soon as the eruption is fully 
out. 

10. Collodion, which we have described on page 528, 
may also be used. 

11. To smear the face over with sweet oil. The 
objection to the use of this and other oils and oint- 
ments is that they are apt to be rubbed off by the 
patient, and leave the face exposed. 

12. The method we are about to mention is one of 
the most recent which has been suggested. It has 
been extensively tried, and with the best results. "We 
recommend it as preferable to many of the other ex- 
pedients which we have just recorded. The latest 
views of the cause of pitting of smallpox, and which 
account for the pitting of the face while the rest of 



844 ON GENERAL DISEASES. 

the body escapes, are that the mischief is done not 
only by the air, but by the light. The object, there- 
fore, is to exclude both light and air. To do this, we 
want a soothing application, one which will allay 
itching. For this purpose the following ointment 
has been recommended, which can be made in any 
household: Mix either butter, free from salt, or fresh 
lard, or simple cerate, with sufficient charcoal to make 
a thick dark paste. Apply this freely upon the face. 
It will exclude both light and air. The patient must 
be watched, and the ointment renewed whenever 
rubbed off. 

13. An English physician, within a few weeks of 
the time we write, has suggested the use of cotton- 
wool to prevent pitting. The idea occurred to him 
when watching; a photographer using cotton-wool to 
shut out the light in the process of "vignetting" 
photographs. He has treated several cases by this 
method, without leaving a vestige of marks. His 

procedure is as follows : On the first appearance of 
f 
the eruption, patches of skin of about an inch square 

are washed over with collodion, and immediately 
covered with a thin uniform layer of fine wool. The 
wool readily adheres if applied before the ether of the 
collodion evaporates. "When the whole of the face or 
other part to be protected is thus covered, the wool is 
to be brushed over with a solution of starch or gum. 
The starch or gum is occasionally to be reapplied to the 
edges of the wool, to prevent any shifting by the move- 
ments of the face, This covering is to be kept on until 
the dry crusts fall off the other parts of the body. 



SMALLPOX. 845 



THE MODERN TREATMENT 

Of smallpox is a great improvement, both in reference 
to the safety and comfort of the patient, over that 
which was formerly in vogue, when blisters, heating 
remedies, warm rooms and wraps were employed. A 
prince of the royal blood of England (John, the son 
of Edward the Second) was treated for smallpox by 
being pat into a bed surrounded with red hangings, 
covered with red blankets and a red counterpane, his 
throat gargled with mulberry-wine, and the red juice 
of pomegranates given him to suck. This was the 
boasted prescription of John of Gaddesden, who took 
no small credit to himself for bringing his royal 
patient safely through the disease. 

REGULATIONS PROPER DURING AN EPIDEMIC OF 
SMALLPOX. 

Every once in a while the community, through 
neglect of the practice of vaccination and revaccina- 
tion, is visited by an epidemic of smallpox, which 
recalls, though faintly, the ravages of this dreaded 
malady before inoculation and vaccination were 
known. The following instructions for controlling 
the contagion, we think, deserve a place here for 
reference in such an emergency. They were care- 
fully prepared by an able body of physicians for recent 
adoption by the Board of Health of the City of 
Lowell. 



846 ON GENERAL DISEASES. 



ISOLATION. 

1. Persons attacked with smallpox or varioloid, and 
all infected clothing of the same, mnst be immediately 
separated from all other persons liable to contract or 
communicate the disease. 

2. Nurses, and all the infected clothing of such 
persons, must be treated as in quarantine. 

3. None but nurses and the attending physicians 
will be allowed access to persons sick with smallpox 
or varioloid. 

4. Patients must not leave the premises until they, 
together with the bed and clothing, have been disin- 
fected, and permission given by some physician. 

DISINFECTION. 

1. All bedding and personal clothing infected with 
the smallpox contagion, which can, without injury, 
must be washed in boiling water. 

2. Infected featherbeds, pillows, and hair-mattresses 
must have their contents taken out and thoroughly 
fumigated, and the ticks washed in boiling water. 

3. Infected straw and excelsior mattresses must 
have their contents removed and buried, and the ticks 
washed in boiling water. 

4. Infected blankets, sheets, and pillow-cases, and 
all articles in contact with or used by the patient, 
must be washed in boiling water. 

5. Personal clothing and bedding, particularly com- 



SMALLPOX. 847 

forters, which cannot be wet without injury, must be 
disinfected by baking or by fumigation. 

6. Instead of using boiling water as the disin- 
fectant, the following chemical process with cold 
water may sometimes be conveniently substituted : 
Dissolve in a wash-tub, containing eight gallons of 
cold water, one pound of the hyposulphite of soda, 
immerse all the articles of clothing and bedding used 
by or around the patient, and, when thoroughly satu- 
rated, add half a pint of sulphuric acid, first diluting 
it with one gallon of water; stir the whole and allow 
the clothes to soak an hour, then wring them out, 
rinse three times in cold water, and hang out to dry. 

7. Disinfection of houses, clothing, and bedding by 
fumigation may be effected by filling the closed rooms 
with the fumes of sulphuric acid or of chlorine gas. 
The first can be accomplished by putting half a pound 
of sulphur in an iron dish, pouring on a little alcohol 
and igniting it, thereby causing the sulphur to burn 
and give off sulphurous acid fumes. The second can 
be accomplished by moistening with water four pounds 
of chloride of lime, contained in an earthen or wooden 
vessel, and adding thereto a pint of muriatic acid, to 
liberate the chlorine gas. Clothing and bedding, to 
be well fumigated, must be separated as much as 
possible, and hung upon the walls and furniture of the 
room, so that everything will be thoroughly perme- 
ated. The rooms should be kept closed an hour or 
two after being charged with gas by either method, 
and then thoroughly ventilated. No attempt should 



848 ON GENERAL DISEASES. 

be made to fumigate the sick-room in this manner 
while it is occupied by the patient. 

8. On the recovery, removal, or death of every case 
of smallpox or varioloid, the clothing, bedding, and 
premises will be disinfected in accordance with the 
above rules, under the direction of one or more physi- 
cians. 

9. The physicians employed in disinfecting may 
cause the removal, destruction, or burial of such 
infected bedding and clothing as may, in their judg- 
ment, seem to require it, of which they shall keep a 
correct record, with date, kind of article, whether new 
or old, estimated value, name and residence of the 
owner. 

10. The sick-room should be kept well ventilated, 
with such precautions as not to expose the patient to 
direct currents of air, and should be occasionally 
fumigated, slightly, by throwing upon a heated sur- 
face a few teaspoonsful of a solution of carbolic acid, 
made by dissolving one ounce of crystallized carbolic 
acid in a quart of rain-water. Pieces of cloth may be 
soaked in this solution and suspended in the room, 
also in the hall-ways adjoining. All vessels for 
receiving discharges of any kind from patients must 
be emptied immediately after use, and cleansed with 
boiling water. When convalescence has taken place, 
the patient must be thoroughly washed in warm 
water and soap, and put on fresh clean clothes 
throughout. 

11. Privies, water-closets, garbage-tubs, water-pipes, 
and all kinds of drains and foul places in houses, 



VARIOLOID. 849 

stables, and yards, may be disinfected with a solution 
made as follows: Dissolve eight pounds of copperas 
(sulphate of iron) in five gallons of water, add one 
quart of the solution of carbolic acid, and mix well. 

12. It should be remembered that there are no sub- 
stitutes for pure air and water. Let fresh air and 
sunlight purify every place they can reach; open and 
dry all cellars; keep the grounds about dwellings dry 
and clean, and let personal and domestic cleanliness 
be everywhere observed. 

VARIOLOID. 

This is a modified form of smallpox which attacks 
those who have been vaccinated, but so long ago that 
the protection has nearly exhausted itself. Although 
the vaccination, in these cases, has proved ineffective 
to prevent the disease, it exerts a marked influence in 
modifying its action and rendering it much milder. 
The danger of varioloid may be entirely averted by 
that proper attention to re-vaccination which on a 
previous page we have urged. 

In varioloid the disease is of a much shorter dura- 
tion. There is no secondary fever, and the life of the 
patient is not often endangered. Neither are the 
effects of the disease as severe as in natural smallpox 
— there being usually but little marking, and rarely 
any affection of the eyes or ears. 



54 



850 ON GENERAL DISEASES. 



Milk-sickness. 



This disease is peculiar to the Southern and West- 
ern States of our Union. It prevails largely in the 
valleys and caves among the mountains of Kentucky, 
Tennessee, North Carolina, Georgia, and in Illinois 
and other Western States. 

This singular affection never attacks man directly. 
It is always derived from the lower animals, by eating 
the flesh of herbivorous cattle, or using the milk or 
butter obtained from them. Besides man, other car- 
nivorous animals derive it from the flesh of herbiv- 
orous animals. The disease appears first, therefore, 
always in the herbivorous classes, the flesh and secre- 
tions of which act as a medium for its transfer to 
flesh-eating animals. It is most frequently met with 
in the cow and horse. 

Prof. Samuel H. Dickson, of the Jefferson Medical 
College, Philadelphia, in an interesting article on 
milk-sickness, says : — 

"It derives its name from the fact that, when occur- 
ring in the human subject, it is most frequently met 
with as the consequence of eating milk rendered 
poisonous by the diseased condition of the cow from 
which it was taken. Butter made from such milk is 
still more acrid, and the flesh of the animal, even 
when cooked, more strongly poisonous than either. 
It is fortunate that the localities in which it resides 
are capable of being defined accurately. Such places 
are often kept carefully fenced in from the intrusion 
of cattle, whose milk is then unhesitatingly used. 



MILK-SICKNESS. 851 

The beautiful valley of Jocassa, in the neighborhood 
of the "White-water Falls, in the upper part of South 
Carolina, was one of these spots, and cattle were not 
allowed to range beyond certain well-known limits. 
The cultivation of soil, which has been known to pro- 
duce it, seems to deprive it of this deleterious quality. 
If animals be kept within their inclosures till late in 
the afternoon, when the dew is entirely exhaled, and 
driven home early in the evening, it is said they escape 
injury, even if allowed to feed within the known limits 
of this poison. It usually affects animals as a chronic 
disease, but sometimes attacks with great violence 
and rapidly proves fatal. My guide to the cascade 
above mentioned informed me that a valuable horse, 
belonging to a neighbor, which had strayed upon the 
dangerous ground and fallen sick, died before he could 
cross the mountain and return. He had gone to bring 
a dose of bear's oil, considered there a specific, and 
lost no time, but was too late to save the life of the 
poor creature. The incapacity to bear exercise is said 
to be so complete a sign of the malady, that the 
owners af cattle give them a hard drive before killing 
them; this excites the disease infallibly if latent in the 
system." 



DISCOVERY OF THE CAUSE OF MILK-SICKNESS. 

Attempts for many years have been made to discover 
the cause of this very curious affection. The legisla- 
ture of Illinois offered some years ago a very large 



852 ON GENERAL DISEASES. 

reward to the man who should make the fortunate 
discovery. 

Dr. O. A. Battson, of Claremont, Illinois, claims 
that he has established, by a series of extended ex- 
periments, the fact that white sndkeroot (Eupatorium 
ageratoides) is the plant which, when eaten by herbiv- 
orous animals, occasions milk-sickness. 

"White snakeroot is an indigenous plant, which 
flowers in August and September, and continues in 
bloom until frost. When in bloom, it is liked by 
animals, which eat of it freely. It resembles, when 
young, in May, June, and July, the nettle. It is a 
branching plant, smooth, three feet high, with broadly 
ovate leaves, which are pointed with sharp thorns or 
teeth. "When the ground is stirred and ploughed 
where the plant grows, it is said to die; it may, there- 
fore, be exterminated by cultivation. 

Dr. Sawyer, of Hillsboro', Illinois, published an 
article on the cause and effects of milk-sickness in the 
Philadelphia Medical and Surgical Reporter for March 
30, 1867, in which he attributes the disease to this 
same plant. He asserts that the "herbivorous animals 
known to be susceptible to the poison are the horse, 
ox, and sheep; the carnivorous are the dog, cat, wolf, 
and their species. Those unsusceptible are the hog 
and deer. Fowls of all kinds are susceptible, not 
excepting the buzzard." 



MILK-SICKNESS. 853 



DURATION OF THE DISEASE. 

From the genuine disease, it is asserted that animals 
never entirely recover. Fifteen years after the attack, 
the least over-exertion, particularly when the weather 
is warm, has been known to cause muscular weakness 
and trembling. Dr. Sawyer says: "It frequently 
happens that drovers purchase cattle which have 
recovered from an attack of this disease, and are 
apparently healthy ; but should they at any time over- 
fatigue them, it will quickly be discovered, for down 
they go wherever they may be; and unless they are 
fed all the corn (best green) they can eat, more or 
less will die; corn seeming to have the same happy 
effect with them, in the cure of the disease, that quinine 
has with man in the cure of the ague. The following 
case, one of the many occurring during the year, is 
an illustration: During the fall of 1865, a drover 
wishing to reach a certain place where he could stop 
with his cattle for the night, and being somewhat 
behind time, urged his drove to a quicker pace. In a 
short time, to his great astonishment, almost at the 
same moment, twelve of the best and fattest steers 
fell out of the ranks, trembling and staggering until 
they fell to the ground, when he was obliged to aban- 
don them to the care of a brother farmer. This 
occurred within three miles of town. I saw the 
cattle a few days afterwards, and would defy any one 
to detect the slightest symptom of disease by simply 

looking at them, for they were apparently as healthy 

t 
as any of their two hundred associates." 



854 OK GENERAL DISEASES. 

Man recovers from the disease somewhat more 
rapidly and thoroughly than animals. But complete 
recovery in his case, after a well-marked genuine 
attack, is the exception rather than the rule. He 
remains for a long time, even for life, subject to dys- 
peptic troubles, and to nausea and vomiting after any 
unusual exertion, especially in warm weather. 

SYMPTOMS OP MILK-SICKNESS. 

Nausea and vomiting, with pain and burning in the 
stomach, are the earliest symptoms which follow the 
feelings of languor and indisposition to mental or 
physical effort ushering in the disease. A peculiar 
odor, it is asserted, is given off from the body. The 
skin is hot and dry, and the eyes are red and glassy. 
The thirst is always very great. After the disease is 
well established, it resembles in many of its features 
typhus fever. 

TREATMENT. 

In some places there is a prejudice in favor of bear's 
oil, as mentioned by Dr. Dickson. This oil is used 
both upon animals and the human subject. In any 
case its effects may be tried. Other oils — sweet oil, 
for example — will doubtless also be found of service. 
Either of these oils may be taken freely. It is hard 
to move the bowels in this affection, not only because 
of the obstinacy of the constipation, but also because 
of the difficulty of keeping upon the stomach for any 
time a sufficient doge of a purgative. 



MILK-SICKNESS. 



855 



As soon as possible after the deleterious food is 
taken, an emetic of warm water and mustard or salt 
should be given. Leeches may then be applied over 
the stomach, and pieces of ice or cold water given 
internally. The bowels are then to be moved with 
castor oil internally, or by means of a purgative injec- 
tion. The patient during recovery should wear warm 
clothing, and avoid exposing himself in any way to 
the weather. Fatigue of every sort must be guarded 
against, as well as improper food. 




CHAPTER VII. 

DISEASES OF THE ORGANS OF BREATHING. 

CONTENTS. 

Cold in the Head. Causes — Is it ever contagious ? — Duration of the attack 
— The symptoms of the disease — The treatment — The dry plan of cure — 
Treatment by the standard domestic remedies. 

Rose Cold, or Hay Asthma. The causes which produce it — The symp- 
toms which characterize it — The treatment which benefits it. 

Cold on the Breast, or Bronchitis. Causes, duration, and mortality of 
the disease — How to recognize it — The treatment proper for children, 
adults, and old persons. 

Chronic Catarrh of the Chest. Circumstances which favor its appear- 
ance — The symptoms — The treatment. 

Pleurisy. Nature of the affection — How caused — Its symptoms — Its treat- 
ment. 

Inflammation of the Lungs, or Pneumonia. Circumstances under which 
it appears — Its duration — How to recognize it — How to treat it : by home 
remedies, by drugs, and the standard domestic remedies — Treatment of 
inflammation of the lungs in children. 

Asthma. The causes and influences which predispose to the disease — The 
. effects of the disease — The duration of an attack — The symptoms — The 
treatment : by common articles, by diet, by domestic plants, by drugs, and 
the standard domestic remedies. 

Consumption of the Lungs. The wide-spread dread of tnis disease — 
Definition of the affection — The circumstances under which it appears — 
Influence of age — Influence of sex — Influence of inheritance — Influence of 
climate — Influence of occupation — Influence of diet — Is consumption con- 
tagious ? — Its mortality rates — The duration of the disease — The symptoms 
— Means of prevention — The curability of consumption — The treatment — 
Diet — Scheme of daily diet — Special articles of food — Exercise in the open 
air — Care of the skin — The clothing — Change of climate — The medicinal 
( 856 ) 



COLD IN THE HEAD. 857 

treatment of consumption — Ccd-liver oil — Iodine — Arsenic — Counter-irri- 
tation — How to relieve the cough — How to check the night-sweats — How 
to stop the bleeding from the lungs — The treatment of the diarrhoea — Use 
of domestic plants in the disease — Treatment by the standard domestic 
remedies. 

Cold in the Head. 



HIS is a very common affection. Few or no 
persons escape it altogether. 
The causes of this disease are numerous. "We all 
know, probably, from our own experience, that it 
frequently arises from exposure to a draft or to the 
night air, from wet and cold feet, from suddenly 
passing out from a warm room into the cold air with- 
out the necessary precautions, from sleeping between 
damp sheets, from the wetting received in an unex- 
pected shower, and from a variety of similar influences. 
But this is not all : frequently the whole community 
is attacked. The temperature suddenly rises or falls 
to a considerable extent, and at once there are great 
numbers of persons with " cold in the head." It is 
not merely a change from heat to cold which does the 
mischief. This is the commonly received theory, and 
therefore most prudent persons sedulously protect 
themselves from effects of an alternation from a warm 
to a cool air. Few know that a sudden transition 
from cold to heat is almost equally dangerous. Thus, 
it is on record that in St. Petersburg, upon a very 
cold winter night in 1782, the thermometer quickly 
rose thirty degrees. Not less than forty thousand 
people had cold in the head on the next morning. 
The prevalence of certain winds in particular locali- 



858 DISEASES OF THE ORGANS OE BREATHING. 

ties is known to favor the development of this trouble, 
whether the wind be cold or warm, dry or moist. In 
England, the southeast wind, which has a peculiar 
haziness, exerts this pernicious influence. 

IS IT EVER CONTAGIOUS ? 

When cold in the head is widely extended and 
severe, when it becomes an epidemic from any of the 
causes we have mentioned, it is known under the 
name of influenza. By some medical writers this 
form of the disease is said to be contagious. And 
many cases of its invasion which have been described 
would seem to support this view. 

But influenza often pervades large tracts of country 
with a suddenness and power too marked to be 
accounted for altogether upon the grounds of conta- 
gion. Contagion is evidently not the only way by 
which the disease may be extended. In the year 1833 
there was a remarkable invasion of a large portion 
of England by this disease. On the 3d of April in 
that year nearly all in London were smitten by it. 
On the same day, the English ship Stag came up the 
channel and arrived on the Devonshire coast, all on 
board at that time being well. In half an hour 
afterwards, the breeze being easterly and from the 
shore, forty men were down with the influenza ; by six 
o'clock the number was increased to sixty, and by two 
o'clock the next day to one hundred and sixty. On 
the evening of the same day, a regiment was on duty 
at Portsmouth, in a perfectly healthy state. By the 



cold rsr THE HEAD. 859 

next morning so many soldiers were sick with in- 
fluenza that garrison duty could not be performed. 

These cases of influenza are more severe than ordi- 
nary attacks of cold in the head. They are attended 
with more decided constitutional symptoms and with 
great prostration of the strength. The suddenness of 
the invasion and the extent and rapidity of the move- 
ments of influenza are sometimes remarkable. The 
influenza of 1781-82 first appeared in China, it thence 
passed rapidly through Asia into Europe, and visited 
our own shores in the following year. 

DURATION OF AN ATTACK OF COLD IN" THE HEAD. 

In its simple and ordinary form, the disease abates 
its violence in three or four days. The accompanying 
fever, which is often very slight, reaches its highest 
point on the third or fourth day, and in about a week's 
time all the symptoms are usually at an end. 

In persons in good health, the disease commonly 
passes away without leaving any after-effects. It is 
never directly fatal, although it may occasion indi- 
rectly loss of life by starting into activity some other 
and more serious affection, such as inflammation of 
the lungs, bronchitis, and even consumption. The ten- 
dency to consumption is not unfrequently, in those pre- 
disposed to the disease, awakened by an attack of cold 
in the head. It is apt also, in those liable to these 
maladies, to be complicated with rheumatic affections 
of the joints, and with neuralgic pains. In old per- 
sons and in infants the course of the attack should 



860 DISEASES OF THE ORGANS OF BREATHING. 

be carefully watched. In the very aged it may give 
rise to inflammation of the bronchial tubes and air- 
cells, which may result in suffocation. In very young 
infants it may lead to the same complications, or occa- 
sion a serious attack of croup. In pregnant women 
the disease sometimes brings on a miscarriage. 

THE SYMPTOMS OF COLD IN THE HEAD. 

A "cold," as it is termed in common parlance, first 
shows itself in unusual dryness of the nostril, which 
seems stuffed up. There is difficulty in breathing 
through the nose, not because there is anything in the 
nostrils, but because the lining membrane is swollen. 
There is heaviness of the head, and some aching of the 
face and jaws. The sense of smell is perverted or lost; 
the nose is unusually sensitive to the contact of air; 
that which is cool or impure readily excites sneezing. 
The eyes become red, and tears flow over the cheeks. 
"With these early symptoms there is apt to be slight 
shivering or chilliness, and a little fever. The pulse, 
particularly in the evening, beats a little more fre- 
quently in the minute than is usual. The lining 
membrane of the nose is at first dry, as we have 
mentioned; soon, however, it begins to secrete a thin 
discharge, which, flowing over the wings of the nose 
and the upper lip, irritates them, and renders them 
sore. After a little while this discharge gets thicker, 
and becomes opaque and yellow. In a short time the 
swelling of the lining membrane of the nose lessens, 
the discharge first becomes natural in quality and then 



COLD IN THE HEAD. 861 

in quantity, and the patient is well. This is the usual 
course of a simple uncomplicated case of cold in the 
head. 

Not unfrequently, however, this cold in the head is 
associated with a cough, pain in the limbs, and con- 
siderable fever. Then we have what is known as 
catarrhal fever. The discharge from the nostrils, in 
these cases, is soon followed by a sense of rawness in 
the throat, an uneasy tickling, and tendency to cough. 
In the language of Prof. Dickson, "The cough is 
rough and painful, and at first dry and hoarse as is 
the voice; but after a while a tenacious mucus is 
expectorated, which, becoming thicker and thicker, 
assumes the color and appearance of pus, its discharge 
being attended with relief. The pulse is frequent and 
rather hard, but not very full ; the skin hot and dry ; 
the tongue white and furred. Pains in the back and 
limbs, and aching as if in the very bones, often ex- 
ceedingly distressing, render motion annoying; and 
the patient complains of stiffness in the joints, with 
more or less languor and debility. There is also, for 
the most part, an inordinate and unaccountable gloom, 
and dejection of the spirits. Rush quotes an invalid 
under his care as saying that the fever not only de- 
served the familiar name of i break-bone,' but should 
be called the c heart-break' also. The fever is distinctly 
of the continued type, reaching its acme about the 
third or fourth day, and running an average course of 
about a week. The height of the exacerbation is 
usually in the evening, when all the symptoms above 
detailed are apt to be aggravated." 



862 DISEASES OF THE ORGANS OF BREATHING. 



TREATMENT OF COLD IN THE HEAD. 

It is in most cases quite easy to avert a threatened 
attack of a cold. Upon the first appearance of the 
premonitory symptoms, such as dryness and stuffing 
of the nostrils, a tendency to sneeze, a fulness and 
heaviness of the forehead, just above the eyes and 
nose, and the other feelings which are usually readily 
recognized as the forerunners of the attack, no time 
should be lost. The patient should go at once to bed, 
and take a ten-grain dose of Dover's powder, or a 
tablespoonful of paregoric, or the febrifuge recom- 
mended among the standard domestic remedies. The 
warmth of the bedclothing, and the sleep induced by 
the action of the remedy, will dissipate in a few hours 
the gathering noxious influences. These precautions 
must be taken early, in advance, as it were, of the 
attack. If carefully followed, they will almost inva- 
riably abort it or cut it .short. 

If it be too late to hope for Success from this method 
of procedure, and the cold in the head be already 
established, then the patient should confine himself 
to his room, if he be at all delicate, for a few days. 
He must keep the head and feet warm, and take hot 
drinks frequently during the day. He should use 
linen pocket-handkerchiefs, not those of cotton or 
silk, and change them frequently. In addition, if 
necessary, he may smear the upper lip with a pleasant 
salve, to protect it from the acrid discharge from the 
nostrils. 

In infants at the breast, the nostrils are to be kept 



COLD EN - THE HEAD. 863 

clean by syringing them with warm water. If they 
have any difficulty in suckling, in consequence of the 
closed condition of the nose, they must be fed by the 
spoon or bottle so long as this obstacle continues. 



THE DRY PLAN OF CITEE. 

A method of cure of cold in the head has been 
recommended by Dr. C. J. B. Williams, and highly 
extolled. It is known as the dry plan of cure. It 
certainly has the merit of simplicity, for it consists 
merely in abstinence from water and every kind of 
drink. No fluids, or next to none, are to be swallowed 
until the disorder is gone. The principle of this treat- 
ment lies in the cutting off of the supply of watery mate- 
rials to the blood. The wants of the system exhaust 
from the circulating fluid all that can be spared for the 
natural evacuations, and there is nothing left to feed 
the unnatural secretion from the inflamed lining mem- 
brane of the nostrils. Its minute vessels cease to be 
swollen; the morbid flow is diverted, and the inflam- 
mation starved away. This is the theory. Habitual 
topers might find the remedy to be worse than the 
disease ; but Dr. Williams asserts that the necessary 
privation is not very hard to bear, and that it achieves 
a cure, upon an average, in forty-eight hours. He 
allows, without recommending, a tablespoonful of tea 
or milk for the morning and evening meals, and a 
wineglassful of water at bedtime. 

A great advantage of this plan of treatment is that 
it does not require confinement to bed, nor even to the 



864: DISEASES OF THE ORGANS OF BREATHING. 

house. The man whose business calljs him abroad, 
may, with proper clothing, pursue his customary em- 
ployment, and his cure is all the time going on. In- 
deed, exercise, as it promotes perspiration, helps on 
the recovery. 

The system of administering warm drinks and agents 
to excite perspiration, renders the body more suscep- 
tible to atmospheric changes. In order that this sys- 
tem of treatment by warm drinks may be properly 
carried out, and without danger, many restrictions are 
needed which are often inconvenient. The dry plan 
of cure has, therefore, certainly the great advantage 
over all others in point of convenience. It must be 
put in force at the very commencement of the dis- 
order. 

When the patient is at all exhausted by the disease, 
tonics are, of course, needed. A few days' holiday in 
the country or at the seaside is of great benefit. 



rose cold, or hat asthma. 865 

Eose Cold, or Hat Asthma. 

This peculiar disease only attacks some persons. 
The majority of people are not affected by it, even 
when exposed to the causes which excite it in those 
who are susceptible. 

It appears at the time of hay-making, and is caused 
by the inhalation of the aroma of spring grass and 
hay. The same complaint is produced in some per- 
sons by the odor of powdered ipecacuanha, and in 
others by that of strawberries. 

Those who are liable to it, escape altogether if they 
avoid meadows and bog-fields, and the neighborhood 
of hay-stacks. Going to the seaside during haying- 
time, therefore, particularly to those parts of the coast 
that are barren of grass, is a sure means of avoiding 
the disease. When this cannot be done, the trouble 
may be escaped by remaining within doors, and shut- 
ting out as much as possible the external air during 
the hay crop. 

Some persons are remarkably susceptible to the odor 
of hay, and find it very difficult to avoid exposure to 
it. The following case, which rests on excellent 
authority, is an illustration of a number of similar 
instances we might present of this singular liability 
to an attack. One lady, who suffered annually from 
this strange affection, states that an attack has been 
brought on by the approach of her children who had 
been in the hay-field. Once this happened when the 
hay harvest had been for some time over, upon their 
joining her at tea, after playing in a barn in which the 

55 



866 DISEASES OF THE ORGANS OF BREATHING. 

hay of that year had been deposited. She was in the 
habit of flying to the sea-coast as the dangerous sea- 
son came on. On one occasion, while walking on the 
shore, she was suddenly attacked by the complaint, to 
her great surprise, as she was not aware of any grass 
being in the neighborhood; but the next day she dis- 
covered that hay-making was in progress upon the top 
of the cliff at the time she was walking under it. In 
another year, after an attack she had suffered had quite 
subsided, and all the hay-making was over, she was 
suddenly visited by the well-known symptoms, and, 
on going into her bedchamber, perceived that they 
were building a large stack of hay in a yard near the 
house, having transferred it from a field five miles dis- 
tant. 

SYMPTOMS OF THE DISEASE. 

These may be described as a combination of those 
which attend an ordinary cold in the head, already 
described, and those of asthma, which we shall shortly 
enumerate. The patient, therefore, has redness of the 
eyes, sneezing and a discharge from the nose, a dry, 
harassing cough, and attacks of difficulty in breathing, 
giving rise to the most distressing sensations of 
impending suffocation. 

THE TREATMENT 

Of hay asthma is easy if the patient can remove him- 
self from the influence of the cause of the disease, but 
very difficult if he must continue exposed to it. 



ROSE COLD, OR HAT ASTHMA. 867 

"Without medical treatment it usually runs a course 
of three or four weeks. 

It is not in the power of every one to leave home to 
escape this disease each year. Therefore the natural 
inquiry of the unfortunates is, what can we do to pre- 
serve our systems against the pernicious effects of 
these, to us, poisonous aromas ? 

The cold shower-bath is recommended as one of the 
best agents for fortifying the system against the 
attack. A combination of quinine and iron is often 
effectual in emancipating patients from this trouble- 
some disorder. The following prescription may be 
given : — 



Take of— 

Quinine, forty grains. 

Sulphate of iron, twenty grains. 

Syrup, sufficient to make a mass. 
Divide into twenty pills and take one three times a day. 



The antiperiodic we recommend among the Standard 
Domestic Remedies is also a very valuable medicine, 
taken twice or three times a day. 

In some cases the odor of chlorinated lime or soda 
exerts a control over the vegetable emanations which 
excite hay asthma. The following experiment may be 
tried. Place saucers of chlorinated lime in the bed- 
chambers, or have rags dipped in Labarraque's solu- 
tion and hang them about the house. Or, pour some 
of the same solution in the water of the washbasin 
and wash the hands and face with it night and 
morning, being careful of the eyes. A small bottle of 



868 DISEASES OF THE ORGANS OF BREATHING. 

Labarraque's solution may be carried about on the 
person and inhaled from every now and then. 

A most excellent preventive and remedy against this 
vexatious disorder is found in arsenic. About two 
drops of Fowler's solution, taken in water, after each 
meal, will be followed, in many instances, by the 
most wonderful and speedy success. 

The use of a good respirator over the mouth and 
nose is sometimes an efficient safeguard. 

During the attack, Dr. Tanner says there is "no 
agent more valuable than tobacco; inasmuch as 
directly the nausea and collapse caused by smoking 
set in, the sense of suffocation will pass of, and the 
patient be enabled to forget his sufferings in sleep." 



COLD ON THE BREAST, OR BRONCHITIS. 869 



Cold on the Breast, or Bronchitis. 

The cold in the head which we have just described 
is very apt to travel downwards into the lungs, and 
then we have a cold on the breast; or, as it is sometimes 
called in common language from one of the most 
prominent symptoms, a cough, in medical language 
bronchitis. 

It is not contagious, and in middle life an uncom- 
plicated attack is not dangerous. In young children 
and old persons the disease is always attended with 
more or less danger. 

The duration of cold on the breast varies. It may 
get well in a few hours or in a few days, passing away 
with the cold weather which ushered it in. In other 
instances it lasts a long time, weary weeks and 
months, and may then lay the foundation of other 
formidable diseases of the chest which may destroy 
the patient. It usually, in favorable cases, begins to 
decline between the fourth and the eighth day. In old 
persons it not unfrequently returns every winter, or 
lasts, with some intermissions, during the whole year. 

how to recognize it. 

The chief symjptoms may be briefly summed up 
as follows : more or less fever ; a feeling of tightness 
or constriction about the chest and of soreness 
behind the breastbone ; hurried breathing, sometimes 
with wheezing ; severe cough, and an expectoration at 
first viscid and glairy, but afterwards thick and often 



870 DISEASES OF THE ORGAN'S OF BREATHING. 

greenish. The quantity of matter expectorated varies 
greatly. In some cases it is quite slight, in others it 
amounts to- half a pint or a pint in the twenty-four 
hours. Very young or old patients sometimes actually 
die suffocated from the immense quantity which is 
suddenly poured out, causing obstruction of the air- 
tubes of the lungs. The pulse is frequent and per- 
haps weak; the tongue is foul; and there is headache, 
lassitude, sickness, and anxiety or depression of 
spirits. 

THE TREATMENT OF COLD ON THE BREAST. 

When the symptoms first appear, when hoarseness 
of the voice and a tendency to cough are first observed, 
the whole trouble may be at once subdued in a healthy 
person by the administration at bedtime of ten grains 
of Dover's powder, taken with a glass of hot lemon- 
ade ; or, by giving five grains of carbonate of ammonia, 
or ten grains of sal ammoniac. If the appetite be un- 
impaired, a full supper, followed by a hot drink, will 
often dissipate all the symptoms of a cold at the out- 
set. Natural sleep will supervene, and the morning 
ought to find the patient well. 

If these remedies are delayed too long to be* of 
service, then the two objects to be aimed at in the 
treatment are to keep up a free action of the skin by 
inducing copious perspiration, and to act freely upon 
the kidneys. 

To properly carry out this treatment, the patient 
should be confined to his bed. It is well for every 



COLD ON THE BREAST, OR BRONCHITIS. 871 

delicate person, especially one who is predisposed by 
family taint to consumption, to take always to his bed 
when an attack of cold on the chest has established 
itself with any severity. 

A good mixture for acting upon the skin and kid- 
neys, and to relieve the inflammation of the bronchial 
tubes, is the following: — 



Take of— 

Wine of antimony, one and one-half fluidrachms. 
Sweet spirits of nitre, one-half fiuidounce. 
Spirits of mindererus, three and one-half fluidounces. 
Brown mixture, four fluidounces. Mix. 



Of this a tablespoonful should be taken every third 
or fourth hour. The bowels are to be kept open by a 
dose of three grains of blue mass at night, followed by 
a Seidlitz powder or a bottle of the solution of citrate 
of magnesia in the morning. 

Or, instead of the above, the following mixture may 
be given: — 



Take of— 

Wine of ipecacuanha, two fluidrachms. 
Paregoric, one fiuidounce. 
Neutral mixture, four fluidounces. 
Syrup, one fiuidounce. Mix. 



Of this the dose is a tablespoonful three times a 
day. 

"When there is much fever, or when the patient 
complains of considerable soreness or pain in the 
chest, a mustard plaster may be applied over the 



872 DISEASES OF THE ORGANS OF BREATHING. 

breastbone. Or, some soap liniment or turpentine 
liniment, or a mixture of both, may be rubbed well 
over the chest. 

In the case of a child, the mustard plaster must be a 
weak one — say one part of mustard to four of Indian- 
meal. If the child be a feeble one and much exhausted 
by the disease, fifteen drops of brandy in milk may be 
given three times a day, to an infant two or three 
years old, together with the following mixture : — 



Take of— 

Carbonate of ammonia, sixteen grains. 

Hoffman's anodyne, one and one-half fluidrachms. 

Syrup of tolu, 

Water, of each, one fluidounce. Mix. 
Give a teaspoonful every two hours, to a child one 
Or two years old. 



For very young children with cold in the chest the 
following liniment is sometimes used as being pre- 
ferable to mustard poultices: — 



Take of— 

Powdered camphor, half an ounce. 
Rub it up well with two teaspoonsful of spirits of 
turpentine and a half tumblerful of sweet oil. 



Saturate a piece of flannel with this liniment and 
apply it to the child's breast, covering it with a piece 
of oiled silk, paper, or muslin, and confining it with a 
bandage. 

A child with this disease must be carefully watched. 
It should not be allowed to remain too Ions: in one 
posture. Never suffer it to lie in one position more than 



COLD OK" THE BREAST, OR BRONCHITIS. 873 

two hours. Serious consequences may result from a 
neglect of this rule. 

In old persons a more stimulating treatment is 
required. Besides the attention to the skin and 
kidneys we have directed, mustard plasters, not too 
strong, should be applied to the chest, and a wine- 
glassful of the decoction of senega given every four 
or six hours. On the first appearance of any sign of 
debility, give the patient, besides a nourishing diet, 
wine-whey to drink. 

A teaspoonful of syrup of squills in a teacupful of 
barley-water is useful, taken several times in the day. 

The inhalation of the vapor of steam is often bene- 
ficial in cold in the chest. This mode of treatment is 
frequently unsatisfactory, because of the difficulty of 
getting an appropriate apparatus, one large enough to 
hold a sufficient volume of water. To overcome this 
difficulty, the following arrangement has been sug- 
gested: Get a large globular glass flask, about eight 
inches in diameter, made so as to receive boiling water 
without breaking. Into the wide mouth of this flask 
put a closely-fitting cork. Through this cork pass one 
glass tube nearly to the bottom of the vessel, and an- 
other tube which descends only a short distance below 
the under surface of the cork. Then attach a rubber 
tube to the latter, and furnish it with a mouth-piece. 
Through this flexible mouth-piece the inhalation is 
made in the same manner as an Eastern uses a nargile 
for smoking through water. 

The patient will make a much quicker and surer 
recovery, as well as be made much more comfortable, 



874 DISEASES OF THE ORGANS OF BREATHING. 

if the air which he breathes be impregnated with mois- 
ture. To keep the air moist, pour boiling water in 
several large flat dishes, which are to be placed near 
the bed. The air of the room should be kept at -about 
a temperature of 65° to 68°. 

If there be much. fever, the febrifuge we recommend 
among the standard domestic remedies should be 
administered. Its use, together with the expectorant 
of the same series, will be usually all the medication 
required. 



chromic catarrh of the chest. 875 

Chronic Catarrh of the Chest. 

This affection is very apt to follow an attack of cold 
in the chest, if the latter be improperly cared for, or 
if the patient exposes himself too mnch during the 
disease or convalescence. The medical term for 
chronic catarrh is chronic bronchitis. 

Age has an influence upon this affection; it is much 
more common in advanced than in early life. Most 
of the cases of "winter cough" in old people are in- 
stances of chronic catarrh of a low, lingering form. 

The disease is not contagious. It may arise directly 
from exposure; or, as is more commonly the case, it is 
the consequence of a cold in the chest imperfectly 
recovered from. 

It is not usually a dangerous affection. It rarely 
causes death itself, but sometimes occasions loss of 
life indirectly by leading to other diseases. 

The main symptoms are an habitual cough, some 
shortness of breath, and a more or less copious expec- 
toration. These symptoms are all made worse by any 
exposure to damp, cold weather, or by any excesses in 
the mode of living. 

THE TREATMENT 

Of chronic catarrh consists mainly in the use of 
stimulating expectorants, and the avoidance of the 
exciting and aggravating causes of the disease. 

One of the best of the stimulating expectorants is 



876 DISEASES OF THE ORGANS OF BREATHING. 

sal ammoniac (muriate of ammonia). The following 
prescription may be given : — 



Take of— 

Sal ammoniac, two drachms. 

Brown mixture, three fluidounces. Mix. 



Of this mixture take a dessertspoonful (two tea- 
spoonsful) three times a day. It will be noticed that 
each dose contains ten grains of sal ammoniac. The 
best results are obtained from giving the remedy in 
this dose; it is perfectly harmless, and any smaller 
dose is nearly useless. For a child, of course, the 
dose of this prescription, like that of all others, is to 
be reduced in accordance with the rules for propor- 
tioning children's doses, given on page 549. 

The expectorant we recommend among the standard 
domestic remedies contains sal ammoniac, very nicely 
combined. It will be found a most efficacious prepa- 
ration. 

Counter-irritation by means of mustard plasters, 
stimulating liniments (soap liniment, ammonia lini- 
ment, etc.), and turpentine stupes applied to the chest 
walls, is beneficial. Blisters are also often of great 
service. 

The covering of the chest with a large warming 
plaster does, in many cases, great good, after the 
above-named remedies have been used for a while. 

Persons affected with chronic catarrh, who have 
made considerable progress in the journey of life, 
require measures which will tend to invigorate the 



CHRONIC CATARRH OF THE CHEST. 877 

general system. A change of climate, when possible, 
is the best of these. The use of concentrated, easily- 
digested food is imperatively demanded. The patient 
must live well. 

The following stimulating application to the chest 
is much used in some of the English hospitals, and is 
highly recommended in chronic catarrh : — 




Take of— 
Spirits of turpentine, a wineglassful. 
Vinegar, a teaspoonful. 
Yelk of egg^ one. 
Rose-water, a wineglassful. 
Oil of lemon, a teaspoonful. Mix. 




This mixture is to be rubbed, morning and evening, 
not only over the chest before and behind, but along 
the sides of the neck. It generally reddens the skin 
and produces small pimples. 

In protracted catarrh of the aged, remedies which 
act upon the kidneys are of great value. The follow- 
ing formulas are of much service in a variety of cases 
of senile chronic catarrh: — 




Take of— 

Nitrate of potash, sixteen grains. 

Sweet spirits of nitre, 

Honey of squills, of each, one fluidounce. 

Decoction of senega, four fluidounces. Mix. 
Give a tablespoonful three times a day. 











878 DISEASES OF THE ORGANS OP BREATHING, 



Or 



Take of— 

Acetate of potash, half an ounce. 

Vinegar of squills, 

Sweet spirits of nitre, of each, one fluidounce. 

Paregoric, half a fluidounce. 

Spirits of mindererus, three fluidounces. 

Syrup of orange-peel, one-half fluidounce. Mix. 
Give a tablespoonful three times a day. 



A useful mixture to be taken when the expectora- 
tion is very thick and tenacious, in order to thin it, is 
the following: — 



Take of— 

Carbonate of potash, half an ounce. 
Wine of ipecacuanha, two fluidrachms. 
Paregoric, 

Syrup of tolu, of each one and one-half fluid- 
ounces. Mix. 
Give a teaspoonful three times a day. 



Or, the following, which is especially useful when 
the patient is weak and needs a tonic : — 



Take of— 

Carbonate of soda, one drachm. 
Sal ammoniac, two drachms. 
Fluid extract of gentian, six fluidrachms. 
Fluid extract of henbane, two fluidrachms. 
Syrup of tolu, two fluidounces. Mix. 
Take a dessertspoonful three times a day. 



The inhalation of the vapor of tar is often of great 
advantage. For this reason, many patients are bene- 
fited by keeping one or two shallow dishes filled with 
tar-water in their bedchambers. 



pleurisy. 879 

Pleurisy. 

This is the name given to an inflammation of the 
delicate membrane which covers the lungs and lines 
the interior of the chest. The disease is a common 
and well-known one. 

Exposure to cold, particularly to drafts of air, is 
one of the most frequent causes of pleurisy. It is 
more generally met with in winter and spring than at 
any other season of the year. The more unsettled the 
weather and the more sudden the changes in the 
temperature, the greater the number of cases in the 
community. 

Simple pleurisy, occurring in one side of the chest 
of a person whose lungs are not diseased, is not a fatal 
affection. It almost always terminates favorably if 
properly treated. But when pleurisy comes on in the 
course of Bright's disease, or when there is tubercular 
disease of the lung, the result may be serious. 

An attack of pleurisy may terminate in a few days, 
but usually lasts a week or ten days, while sometimes 
many months elapse before the patient is well. 

SYMPTOMS. 

The first sign is usually a sharp pain or stitch in 
the side, more frequently the right than the left. It 
is generally situated just below the nipple, is of a 
dragging, shooting character, and is greatly increased 
by coughing, taking a long breath, or lying on the 
affected side. The patient is apt to carry himself 



880 DISEASES OF THE ORGANS OF BREATHING. 

bent over towards the painful side. The breathing is 
short and restrained, because of the pain attending it. 
There is a short, harsh cough, the skin is hot and dry, 
and the cheeks are flushed. The signs of fever, how- 
ever, in mild cases, are very slight, and may escape 
detection. In fact, it not unfrequently happens that 
a person passes through an attack of pleurisy without 
knowing that he has had it. These attacks, however, 
though unnoticed at the time, often leave behind them 
ill effects. The neglected inflamed membrane con- 
tracts adhesions w r hich give rise to more or less 
trouble and pain in breathing for months or years. 
In severe cases of this hidden pleurisy, in which there 
is no pain, cough, nor shortness of breath which 
excites particular attention, the disease may go on to 
such an extent as to fill one side of the chest with 
fluid. This stealthy character of the invasion is quite 
rare, the disease usually showing itself early by the 
sharp pain, cough, and fever we have mentioned. 

TREATMENT. 

Enveloping the side of the chest in a very large 
and very hot flaxseed-meal poultice, prepared and 
applied as directed on page 519, is an excellent mode 
of treatment, and will often check the disease at once. 
In addition, the patient should take ten grains of 
Dover's powder, or a dose of the febrifuge of the 
Standard Domestic Kennedies, at bedtime. To relieve 
the cough, give every few hours a teaspoonful of pare- 



PLEURISY. 881 

goric, with half a teaspoonful of sweet spirits of nitre, 
in a half wineglassful of water. 

The patient must be kept warm and quiet in bed, 
and forbidden to talk, as conversation irritates by the 
friction it occasions of the inflamed part. 

"When the pain has ceased for some days, but the 
oppression in breathing continues, then the applica- 
tion of a few small blisters to the affected side of the 
chest is serviceable, and tends to prevent dropsy of the 
chest, which is one of the consequences to be most 
feared of an attack of pleurisy. Instead of blisters, 
the side of the chest may be painted twice a day with 
a mixture of equal parts of tincture of iodine and 
alcohol, or mustard plasters may be applied. 



56 



882 diseases of the organs of breathing. 

Inflammation of the Lungs. 

Inflammation of the lungs, or lung fever, or, in medi- 
cal language, pneumonia, is a much more serious affair 
than inflammation of the membrane covering them 
(pleurisy), which we have just been considering. 

The general prevalence of this affection, and the fact 
that it opens a large and familiar outlet to life, render 
a knowledge of its nature and treatment of much 
interest. During our late civil war, the death-rate in 
both armies from this disease w T as very high. 

In pneumonia, the actual substance or true tissue 
of the lungs is inflamed. Sometimes one lung is 
attacked, sometimes, in about one case out of five, 
both, constituting double pneumonia. The right lung 
is the one more frequently selected by this disease. 

THE CIRCUMSTANCES UNDER WHICH IT APPEARS. 

Inflammation of the lungs assails all ages, but is 
comparatively rare before five years of age. It ac- 
quires very great frequency between twenty and thirty. 
After sixty years of age it is one of the most common 
and fatal of diseases. 

Sex is supposed to exert an influence in the devel- 
opment of the disease, as more men than women are 
affected. But this difference is more apparent than 
real. It is probably due altogether to the fact that in 
the ordinary vocations of life men are more exposed 
to vicissitudes of temperature and to cold and mois- 
ture, the main causes of the disease, than women. 



INFLAMMATION OF THE LUNGS. 883 

The disease prevails, as a rule, more extensively 
during the spring and late winter months than at any 
other season of the year. 

Pneumonia is not contagious. Its most common 
cause is exposure to cold, aided by dampness. 

The duration of the disease varies very greatly in 
different cases. Taking it in all its forms, a case 
usually terminates, favorably or unfavorably, between 
the seventh and twentieth day. 



HOW TO RECOGNIZE IT. 

Pneumonia is not unfrequently ushered in by an 
attack of cold in the chest, which, instead of progress- 
ing to recovery, lights up inflammation of the lung- 
structure. Frequently, wandering pains in the limbs 
and chest, loss of appetite, and general debility 
precede, for several days, any definite attack. In old 
persons a dull pain about the nipple is often com- 
plained of several days before other symptoms appear. 

The attack usually comes on with a marked chill, or 
a creeping may last for several hours or during a 
night and repeat itself once or twice during the first 
and second days. This chill is in old persons almost 
invariably the first symptom noticed. "When the 
chill passes away, the patient is left hot and flushed, 
with shortness of breath, and a feeling of weight and 
oppression somewhere in the chest. This sense of 
uneasiness soon increases to a dull, heavy pain. 

The disease being established, the patient is restless 
and uneasy. He breathes rapidly, but with pain and 



884 DISEASES OF THE ORGANS OF BREATHING. 

difficulty. His cough, which is of an anxious and 
unsatisfactory character, is at first dry, but afterwards 
attended with expectoration of a rusty color streaked 
with blood. 

A patch of deep red on one or both cheeks is very 
constantly present during the early stages of inflam- 
mation of the lungs. This peculiar flushing of the 
cheek is so characteristic that it enables the experi- 
enced eye to tell from it alone of the existence of the 
disease. "When one cheek only is flushed, it does not 
follow that the lung of the same side is the affected 
one; it is quite as likely that the opposite is the 
diseased one. 

The expectorated matter in pneumonia is quite pe- 
culiar. It presents an appearance unlike the expec- 
toration in any other disease of the lungs. This is- 
caused by the more or less amount of blood which is 
mixed with it. Sometimes the color resembles closely 
that of iron-rust, with specks like those of brick-dust 
on the surface. Often it is of a brownish-yellow hue, 
like tobacco-juice, and in severe cases it frequently 
looks like licorice or prune juice. 

When the pain in the lungs is severe, patients gene- 
rally lie upon the back or else upon the affected side. 
When the greater part of one or both lungs is solidi- 
fied by the disease, occasioning much embarrassment 
of the breathing, the patient prefers to lie on the back 
with the head and shoulders raised. 

As the patient gets better, the expectoration loses 
its peculiar appearance, increases in quantity, and is 
raised more easily. The breathing is relieved, and 



INFLAMMATION OF THE LUNGS. 885 

the number of respirations in the minute lessened. 
The fever passes away, and the skin becomes cool and 
moist. The appetite returns, and flesh and strength 
are rapidly regained. 

When the case proceeds to a fatal termination, the 
breathing is quickened, the patient gasps for air, the 
face becomes pale, the surface of the body cold and 
clammy, the expectoration thinner and of a darker 
color, or stops altogether, the strength rapidly fails, 
there is low delirium or loss of consciousness, and 
death ensues from suffocation. 

THE TEEATMENT 

Of inflammation of the lungs requires not a single but 
• many agents, varying with the peculiarities of the case. 
For instance, in some cases but little medical inter- 
ference is required, careful nursing, a well-regulated 
diet, and supporting or stimulating drinks being all 
that is needed. In other cases the most active stimu- 
lant is called for to prevent the patient from sinking, 
and, in some, low diet and depressing remedies are 
demanded. The cases calling for these diverse 
methods of treatment we shall endeavor to designate 
as we proceed. 

Attention must first be paid to the bowels. A dose 
of castor oil or of citrate of magnesia, or of the cathar- 
tic of the Standard Domestic Remedies, is to be admin- 
istered, if needed. The patient is to be kept per- 
fectly quiet in bed. The air of the room requires 
looking after. It should be kept moist by the evapo- 



886 DISEASES OF THE ORGANS OF BREATHING. 

ration of boiling water, and the temperature should 
not be allowed to fall lower than 65°. 

The affected side is to be enveloped in large hot 
poultices of flaxseed, mashed potatoes, or corn-meal, 
covered, of course, by oiled silk, paper, or muslin, to 
confine the warmth and moisture. These poultices 
should be carefully made in accordance with the direc- 
tions given on page 519, and when renewed should be 
immediately replaced by the fresh poultice, in order 
that the skin shall not be exposed for .a moment. In- 
stead of the poultices, some physicians employ cotton- 
batting, plentifully padded over the affected side of 
the chest. If the pain be severe, turpentine stupes 
may be applied night and morning. 

The well-known English physician, Dr. Chambers, 
is a strong advocate of the use of the poultice in this 
disease. He prefers that made of flaxseed-meal, be- 
cause it keeps moist the longest. It should be spread 
half an inch thick on a piece of cloth or flannel, broad 
enough to extend all around the chest, and deep enough 
to extend from the collar-bones to the lower margin of 
the ribs. Cover the poultice with a thin piece of 
gauze, which is to be stitched in at the sides. Lay the 
patient on it on his back, and fold it across the front 
until it meets. In adults this jacket poultice will 
usually keep its place of its own accord; but in chil- 
dren there should be a tape sewed on in front, and a 
tape behind, which can be tied over each shoulder in 
the manner of a shoulder-strap, as otherwise the little 
prisoners wriggle out of their soft breastplates. When 



INFLAMMATION OF THE LUNGS. 887 

once this poultice is in position, it is to be kept there, 
and not removed until a hot one is ready to go on. 

It is of the utmost importance that quiet of body 
and mind should be secured for the patient during the 
whole course of the illness. A neglect of this occa- 
sions many a fatal result. 

The diet should be light, but nutritious. Milk is to 
be given from the first, and a plentiful supply of cold 
water. As the disease advances, strong beef-tea and 
concentrated animal broths are to be administered. 

If the patient be delicate, or if his strength is 
rapidly failing, wine and even brandy or whiskey are 
to be given. These, however, should never be looked 
upon as taking the place of food. They are merely 
stimulants, which it is necessary sometimes to admin- 
ister, but the necessity for the use of which is to be 
prevented, if possible, by nourishing food. 

There are few patients at the present day who re- 
quire, or indeed can bear, a lowering treatment in this 
disease. Bloodletting and a low diet are rarely pro- 
per, and it is never safe to resort to them excepting 
under intelligent medical advice. Most cases of lung 
fever do best under a generous restorative system of 
food and drugs. 

When the crisis of the disease occurs by diarrhoea 
or sweating, it must not be unnecessarily checked. 
During recovery, particular attention must be paid to 
the diet, in order that it may be as nourishing and as 
easily digested as possible. 

In some very severe cases, the only question, as Dr. 
Tanner well says, is how to keep the patient alive, 



888 DISEASES OF THE ORGANS OF BREATHING. 

until the exuded matter, occupying the air-cells and 
tubes, becomes absorbed. Under these circumstances 
brandy is invaluable, and is to be administered freely, 
even in some instances to the extent of a dessert- 
spoonful or tablespoonful, in water or milk, every 
hour or two for several days. The essence of beef in 
these cases (for receipt, see page 492) will prove of 
service. In comparatively few cases, however, is such 
active stimulation as this required. 

When the patient is feeble, a very pleasant draft 
is made by dissolving in one wineglassful of water a 
scruple of carbonate of ammonia, and in another a 
scruple of citric acid, and then mixing the two in a 
tumbler and drinking while frothing. 

The following mixture is a serviceable one for 
allaying the cough and lessening the congestion of 
the lungs : — 



Take of— 

Bicarbonate of potash, two drachms. 

Syrup of gum Arabic, three fluidounces. Mix. 
A dessertspoonful in water is to be taken four, six, 
or eight times in the twenty-four hours. 



During the latter period of the disease, and during 
convalescence, a most excellent tonic is quinine, a 
two-grain powder or pill of which should be given 
three or four times a day; or, still better, the tonic of 
the Standard Domestic Eemedies administered. 



INFLAMMATION OF THE LUNGS. 889 

TREATMENT OF INFLAMMATION OF THE LUNGS IN 
CHILDREN. 

The little patient must be kept in bed, in a room 
of a temperature of about 65°, and with the air kept 
moist by the evaporation of boiling water. The diet 
should be milk during the height of the fever ; as the 
skin cools, good beef-tea is to be given, and a simple 
mixture like the following : — 



Take of— 

Citrate' of potash, one scruple. 

Syrup of orange-peel, two fluidounces. 

Water, sufficient to make two fluidounces. Mix. 



The dose is one or two teaspoonsful three or four 
times a day. 

The poultice-jacket is of course to be worn, but 
neither blisters nor bloodletting are to be resorted to. 



890 DISEASES OF THE ORGANS OF BREATHING. 
/ 

Asthma. 

This is one of the most persistent and obstinate 
diseases of which we have any knowledge. Relief 
may often be had from the severity of the affection, 
but a cure is difficult to obtain, as many an asthmatic 
patient bears unwilling witness. 

Age exerts, apparently, little influence on the de- 
velopment of this disease. It occurs at all periods of 
life, from early infancy to extreme old age. It has 
been noticed in infants only fourteen days old. Many 
of the best-marked and most persistent cases date 
from such an early period of life, that it is difficult to 
say whether the disease was not born with the patient. 
Indeed, there is little doubt that it is frequently 
hereditary, and sometimes transmitted through several 
generations. When not hereditary, it usually appears 
between thirty and forty years of age ; when heredi- 
tary, it is most apt to show itself about the age of 
puberty. 

Sex is a predisposing cause, for the disease is more 
common among males than females. According to 
some authorities, eight patients out of ten are males. 

The previous health has also an influence, for many 
attacks are connected with a gouty or rheumatic state 
of the system. The connection of asthma with a 
gouty constitution is quite marked. In many in- 
stances both gout and asthma can be traced in the 
same family, the members being alternately subject 
to the one and the other disease. It has also been 
noticed that when women are the subjects of asthma, 



ASTHMA. 891 

gout prevails in their families in a larger proportion 
than in those of men. 

The seaso7i of the year and weather are among the 
circumstances which predispose to it. An attack is 
most apt to appear in the spring or autumn months, 
and after exposure to cold and wet. 

The influence of particular atmospheres and climates 
is well known, but not readily accounted for. Why 
should one asthmatic be unable to sleep in a smoky 
and dirty city, while another can live in comfort 
nowhere else? "Why should the noxious close atmos- 
phere of a crowded room or ship's cabin be the balmi- 
est of airs to some asthmatics, who are only easy when 
breathing it, while to others a single inhalation of 
such depraved air will bring on a severe asthmatic 
seizure? 

The diet has sometimes much to do with bringing 
on an attack. Full meals and late suppers, particu- 
larly if the food be unusual or indigestible, are peril- 
ous to those predisposed to the disease. 

A connection between violent exercise by running, 
walking, singing, or leaping; fatigue of the voice by 
singing or talking; electrical conditions of the atmos- 
phere, as in thunderstorms; and attacks of asthma, 
has been noticed. 



EFFECTS OF THE DISEASE. 

Death rarely or never results directly from asthma. 
"So matter how nearly suffocated in an attack the 
patient may appear, he will quite certainly recover his 



892 DISEASES or THE organs of breathing. 

breath. The symptoms of impending suffocation, 
though prominent, and painful to witness by one 
unaccustomed to seeing them, need, therefore, excite 
no alarm. There is a common opinion that asthmatic 
people enjoy better general health and live longer than 
others. If this be true, it may be accounted for 
perhaps on the ground that they are obliged to take 
better care of themselves than most of us, any indis- 
cretion producing a painful attack. In many instances, 
however, the disease, although it does not curtail life, 
lessens materially the pleasure of living and impairs 
the general health, weakening the muscles, destroying 
the tone of the digestive organs, and emaciating the 
body. 

The duration of a fit of asthma varies from a few 
minutes to several hours. It not uncommonly lasts 
during a whole night, sometimes several days or 
weeks. Patients sometimes get well entirely of the 
disease, but, as a rule, one who had a single fit of 
asthma will have others at intervals during life. 



THE SYMPTOMS 

Of asthma are easily recognized. 

A fit of asthma usually comes on in the evening, 
just after getting into bed and before going to sleep; 
but also often in the early morning, between three and 
six o'clock. The attack is sometimes attended or pre- 
ceded by neuralgic pains, disturbances of the stomach, 
nausea and vomiting, or a loose, griping stool. The 
characteristic wheezing generally commences while 



ASTHMA. 893 

the patient is yet asleep. He is aroused by it, and 
obliged to sit up in bed. He is unable to bear the 
weight of the bedclothes or the pressure of anything 
tight around his chest. He seeks fresh air, and assumes 
various positions to aid him in his attempts to fill the 
lungs. The shoulders are heaving convulsively, the 
eyes staring, and the countenance anxious. The 
patient looks as if he were dying. He is either irri- 
tated by his condition or distressed by it, and implor- 
ing with his eyes relief from his severe sufferings. 
The cough is generally loud and frequent, though 
sometimes low and husky, and in others suppressed 
entirely, in consequence of the great debility of the 
patient. In these latter cases the suffering is of 
course more acute. Gradually some expectoration 
appears, and a temporary abatement occurs in all the 
symptoms. The patient may then fall asleep, only 
again perhaps to be awakened by a renewal of the 
struggle in all its first severity. 

The approach of a fit is sometimes announced from 
afar, often it arrives without any warning. The pre- 
cursory symptoms, when present, vary with different 
persons. The patient soon learns to recognize them, 
and to prepare for the coming event. Some suffer 
from a severe headache in advance of the asthmatic 
seizure. In others, eruptions present on the skin les- 
sen or disappear. In some instances, just before the 
attack, the patient is warned by the huskiness of his 
throat. Strange to say, some attacks of asthma are 
ushered in a day or two in advance by great buoyancy 
of the spirits. Unusual mental activity and obstinate 



894 DISEASES OF THE ORGANS OF BREATHING. 

wakefulness are in some premonitory of an attack. 
Itching under the chin is a common forerunner of an 
approaching fit. This itching is constant, of a pecu- 
liar creeping character, and unrelieved by scratching. 
Sometimes it extends over the breastbone and between 
the shoulders. It appears ordinarily the first moment 
that tightness of breathing is felt, and subsides as the 
fit passes off. 

THE TREATMENT 

Of asthma naturally divides itself into treatment of 
the fit, and the treatment which should be instituted 
during the intervals in order to correct the constitu- 
tional state which every now and then culminates in 
an asthmatic fit. 

THE MANAGEMENT OF THE FIT OF ASTHMA. 

During the attack, the objects aimed at are a pallia- 
tion of the suffering, and the shortening of it. When 
the stomach is filled with undigested food, an emetic 
(a teaspoonful each of salt and mustard in a tumbler 
of warm water) will be of service; when the bowels 
are overloaded, an injection is to be given. For the 
relief of the spasmodic breathing quite a number of 
remedies are in use, some of which succeed in certain 
cases. That which benefits one asthmatic patient 
often has no effect upon another. Among the reme- 
dies we are about to mention, almost every patient 
can find one at least which we think will prove a friend 
in time of need. First we will mention 



ASTHMA. 895 

Nitre-paper Fumes. — This affords much relief in many 
cases of asthma. Frequently this remedy fails of 
effect because the nitre-paper is not properly prepared. 
The following directions should be noted: Dissolve in 
some water all the nitre (saltpetre) it will take up; 
then take some ordinary red blotting-paper, dip it into 
this concentrated solution, and allow it to dry. "When 
wanted for use, set it on fire in an open vessel, covered 
with a newspaper made into a cone, so that the fumes 
may be inhaled. Or, it may be burned in an earthen- 
ware dish, and the fumes allowed to diffuse themselves 
throughout the room. 

The following formula, for the preparation of a paper 
to be burnt for the relief of asthma, is recommended 
upon good French authority as superior to the ordi- 
nary nitre-paper. The asthmatic patient may get it 
made for him by his apothecary, and keep it on hand 
for use : — 

Take four ounces of white paper, and allow it to macerate 
in warm water until reduced to a uniform paste. Then press 
out the greater portion of water, and mix the residue in a 
mortar with the following powder: Nitre, 2 ounces; myrrh 
and olibanum, of each, 2 J drachms ; belladonna, stramonium, 
and digitalis, of each, 10 grains. When a uniform mass has 
been formed, roll out into sheets a line or so thick ; dry, and 
cut into strips. 

This paper is said to burn less quickly than the 
ordinary nitre-paper, and to be more effective. 

Strong coffee is sometimes of great service in avert- 
ing or relieving a fit of asthma, made of the strength 
of two ounces of Mocha to the cup. 

Dr. Monell has recently strongly recommended 



896 DISEASES OF THE ORGANS OF BREATHING. 

forced hreatliing for the relief of asthmatic seizures. 
The directions to be observed are as follows : — 

The patient is to expel from his lungs all the air it 
is possible for him to, and not to draw any in until it 
is found absolutely necessary. Then the inspiration 
is to be carried to its fullest extent, extending the 
lungs to their utmost capacity, and the air retained 
for many seconds. This act of forced expiration, 
holding the breath, then of thorough inspiration, and 
again holding the breath, is to be continued for some 
fifteen minutes, when it will be found that the fit is 
relieved. It requires great exertion on the part of the 
patient to perform this act. The first attempt at hold- 
ing the breath with the lungs filled with air, will cause 
the patient to think he cannot continue it, but per- 
severance will soon delight him with relief from the 
spasm. 

TJwrn-apple ( Jimson-weed) is an excellent remedy 
in some cases. A few whiffs from a pipe filled with 
it or from a cigar, act like a charm on certain 
patients. Unfortunately, in many instances it is 
almost worthless. The drug must be gotten good, 
and it should be known that the seeds are much 
more powerful than the cut up leaves and stalk. 

Chloroform has been employed with success in a 
number of cases to relieve the attack; in some, how- 
ever, it has been found to do harm. It is not a safe 
remedy out of the hands of an experienced physician, 
as death may readily ensue from careless administra- 
tion. It should not be self-prescribed or self-admin- 
istered. 



ASTHMA. 897 

Ether is much safer than chloroform, and often 
quite as effective. Moreover, it does not nauseate 
the patient like the prolonged use of chloroform does. 
It is frequently very agreeable to the asthmatic. It 
should never be inhaled to complete insensibility. A 
handkerchief or sponge may be partially wet with it 
and the vapor inhaled by the patient carrying it near 
to the mouth and nose. There is then no danger, for 
so soon as the slightest unconsciousness comes on 
the hand falls, and the handkerchief or sponge drops 
from it. 

Tobacco, to those unaccustomed to smoking, by the 
nausea it produces, affords relief. It should be 
smoked in a pipe when a fit seems impending. 

Lobelia, an American plant, known also under the 
names of Indian or wild tobacco, poke-weed, and 
asthma- weed, enjoys a high reputation in the treatment 
of asthma. Twenty or thirty drops of the tincture 
may be given every half hour during the fit, until 
nausea is produced or the breathing relieved. Instead 
of the tincture, the powder may be used in doses of 
five or ten grains. 

Hoffmanns anodyne is an old and approved remedy. 
Thirty drops may be taken in water every half hour 
during the attack. Or, it may be combined with 
lobelia, as follows : — 



Take of— 

Tincture of lobelia, 

Hoffmann's anodyne, 

Syrup of tolu, of each, one fluidounce. Mix. 



57 



898 DISEASES OF THE ORGANS OF BREATHING. 

Of this mixture the dose is a teaspoonful, in water, 
every half hour during the fit, until some effect is 
produced on the breathing. Then it is to be given 
every hour or two. 

"When the familiar symptoms which forewarn the 
patient of the coming on of a fit are noticed, it may 
be prevented by swallowing a pill of a quarter of a 
grain or half a grain of the extract of thorn-apple 
(stramonium) just before sleeping. 

The above remedies have all reference to the treat- 
ment of the fits. "We will now give some information 
in regard to what is to be done during the intervals, 
to prevent a recurrence of the attacks. 

THE TREATMENT DURING THE INTERVALS. 

The patient must avoid whatever he has found by 
experience disturbs his general health. He must look 
out for his digestive organs, and be temperate in all 
things. He should avoid those localities and those 
odors which, he has observed, do him harm. The daily 
use of the shower-bath has been strongly advised as 
a practice calculated to fortify the system against the 
attacks. 

The diet is particularly important. It is perhaps 
not too much to say that most cases are under the 
control of well-regulated dietetic management. Many 
physicians regard the dietetic treatment as the only 
certain one for asthma. "More is to be done for asth- 
matic patients on the side of the stomach than in any 
other direction." 



ASTHMA. 



899 



An English physician, Dr. Pridham, has been ex- 
ceedingly successful in treating asthma by means of 
a strict dietetic management, together with the use of 
sedatives, etc. His plan of treatment is about as fol- 
lows : — 

First, correct the condition of the bowels by the 
following pill at bedtime, succeeded by a dose of ci- 
trate of magnesia, cream of tartar, or Epsom salts in 
the morning: — 



Take of— 

Aloes with myrrh, three grains. 
Blue mass, one grain. 
Extract of dandelion, two grains. 
Extract of thorn-apple, one-half grain. Mix. 
Divide into two pills. Take one as above directed. 



Or, take the following pill every other night, and on 
the next morning a dose of cream of tartar or citrate 
of magnesia: — 



Take of— 




Blue mass, four grains. 




Powdered ipecac, one grain. 


Mix. 


. For one pill. 





After having followed the above line of treatment 
for ten days, and gotten the bowels and secretions in 
a healthy state, then the strict dietary system is to be 
commenced. 

The diet must be regularly weighed out, and adhered 
to with the greatest strictness, the hours of meals 
being most rigidly fixed as follows: — 

Breakfast at eight A.M. ; to consist of half a pint of 



900 DISEASES OF THE ORGANS OF BREATHING. 

green tea or coffee, with a little cream, and two ounces 
of dry stale bread. 

Dinner at one P.M.; to consist of two ounces of 
fresh beef or mutton, without fat or skin, and two 
ounces of dry stale bread or well-boiled rice. 

Supper at seven P.M. ; to consist of two ounces of 
meat as before, with two ounces of dry stale bread. 

The patient must not drink any fluid whatever, 
within one hour before his dinner or supper, and not 
until three hours after either of these meals. At other 
times he need not limit himself as to drinks, except- 
ing to avoid all malt liquors. Soda-water may be 
indulged in at all times when thirsty. 

Together with this dietetic treatment, the following 
sedatives are to be given : — 

One grain of the extract of hemlock is to be taken 
four times a day — namely, at the hours of seven, 
twelve, five, and ten. The dose may be gradually 
increased to two grains four times a day. 

The extract of Indian hemp may be combined with 
the hemlock, one-fourth of a grain being added to 
each dose of the latter. 

It is said that under this treatment the distressing 
symptoms may be expected to subside in a few days. 
After the restricted diet has been persevered in for 
at least a month, two ounces more of meat may be 
permitted, if the digestion is found to be sufficient. 
Care must be taken that the stomach be not called 
upon to do more than it can accomplish. The powers 
of digestion are known to be recovering when the 
stomach craves for food as the hour of nourishment 



ASTHMA. 901 

arrives. As flesh is gained, strength improves. The 
patient is thus encouraged to persevere, particularly 
if, as ought to be the case, he can sleep six or seven 
hours at a time or lie in bed all night. 

If these results follow this dietetic treatment, the 
ultimate cure of the disease may be looked for ; but 
it may at the same time be taken for granted that the 
asthmatic cannot without danger eat and drink like 
other people. It is only by the exercise of self-denial 
that the patient has it in his power to live a life of 
comparative ease and comfort. 

But many people have not the resolution to carry 
out these directions and persevere in them for at least 
six months, and others fear that by so doing they will 
injure their constitution. In view of this difficulty, 
and the fact that asthmatics are generally dyspeptics, 
Dr. Hyde Salter has laid down the following simple 
rule in regard to diet, which all can observe without 
much sacrifice. Let no food be taken after such a 
time in the day as will allow digestion being com- 
pleted or the stomach being empty before going to 
bed. The time when the last solid food should be 
taken will depend upon what the bedtime is. If ten 
or half-past ten, no solid food should be taken later 
than four or five o'clock in the afternoon. 

Dr. Salter's dietary in cases of asthma is something 
as follows : Breakfast — A breakfastcup of bread and 
milk, an egg or a mutton-chop, or some cold chicken 
or game. Tea is better than coffee, and milk and 
water better than either. Dinner — Mutton ought to 
be the staple diet, beef or lamb rarely, pork or veal 



902 DISEASES OF THE ORGANS OF BREATHING. 

never. Juicy vegetables or potatoes may be eaten, 
and a little plain pudding or stewed fruit, or fruit out 
of a tart, should conclude the dinner. Water is the 
best fluid to drink, and there should be no cheese and 
no dessert. As the amount of food eaten should be 
small, it ought to be plain, simple, and nutritious in 
character. 

Either of these dietetic modes of treatment, Dr. 
Pridham's or Dr. Salter's, may be adopted by the 
patient. We have seen, in our own practice, the best 
effects, even in severe cases, from a steady persever- 
ance in a well-regulated course of diet. 

Exercise in the open air is of much importance to 
the asthmatic patient, but it should never be carried 
to the point of fatigue, and no great physical exertion 
is to be made within three hours after taking animal 
food. The utmost regularity must be observed in all 
the habits and functions of the body — and, if possible, 
both body and mind are to be kept at rest for an hour 
after each meal. 

A medicine recently recommended in asthma is 
worthy of trial in all cases. In some instances it works 
wonders. This medicine is iodide of potassium. It 
may be taken in five-grain doses, in syrup and water, 
three times a day. Or, the following formula may 
be employed: — 



ASTHMA. 



903 



Take of— 
Iodide of potassium, one and one-half drachm. 
Aromatic spirits of ammonia, one and one-half 

fluidounce. 
Tincture of belladonna, two fluidrachms. 
Huxham's tincture of bark, one and one-half 
fluidounce. Mix. 
Take a teaspoonful, in a wineglassful of water, three 
times a day. 



The alterative recommended in the chapter on 
Standard Domestic Eemedies will be found a most 
excellent prescription in the intervals between the 
attacks. 

The details in regard to the treatment of the asth- 
matic fit, and of the intervals between the seizures, 
which we have just given, cannot, in our opinion, fail 
to be of benefit to every asthmatic patient. 



904 diseases of the organs of breathing. 

Consumption of the Lungs. 

Of no disease, probably, is there greater dread in 
the public mind of America than of consumption. 
The word suggests an incurable condition; it recalls 
to the memory of almost every reader the sufferings 
and death of more than one related by the ties of 
friendship or of consanguinity. Who of us have not 
suffered in our hearts, if not our homes, from the 
ravages of this relentless foe of modern life? who of 
us have not reason to fear its attacks upon those 
dear to us? Some who read these pages doubtless 
tremble for their own safety, and put the anxious 
inquiry, What shall I do to escape the sad fate which, 
like the sword of Damocles, seems suspended above 
and about to fall upon me? Others, conscious that 
the disease has already obtained a foothold, desire to 
lessen their sufferings and prolong their lives. We 
write in the hope that some of the facts and counsels 
in regard to the nature, origin, prevention, and cure of 
this affection, which we are about to record, may 
prove of service to the reader, whether his fears are 
for himself or for those about him. 

DEFINITIONS. 



Consumption of the lungs, or pulmonary consump- 
tion, is generally spoken of by physicians under the 
name of phthisis, or tubercular phthisis, or phthisis 
pulmonalis, or tuberculosis of the lungs. We shall 
only employ throughout this article, as we have else- 



CONSUMPTION OF THE LUNGS. 905 

where in the book, the common name. Consumption 
of the lungs may be denned as the growth or the 
exudation into the lungs of a peculiar material, in the 
form of small masses, or tubercles, as they are techni- 
cally called. These tubercles undergo various changes 
in the lungs, and their presence is preceded by, and 
associated with, the signs and symptoms of scrofula. 

Consumption is a scrofulous disease of the lungs, 
as we pointed out in treating of scrofula in a previous 
chapter. It can only affect those with a scrofulous 
taint of the system ; it is merely a form of scrofula in 
which the lungs are principally and most conspicu- 
ously affected; it is a fragment of a great constitu- 
tional malady; it is not, therefore, exclusively a lung 
disease. 



THE CIRCUMSTANCES UNDER WHICH IT APPEARS. 

Influence of Age. — No age seems to be exempt from 
this scourge. Children are less apt to be affected by 
it than adults, for with them scrofulous disease shows 
itself in the various forms of external scrofula which 
we have described in our chapter on the subject. At 
and after the age of puberty, consumption is the most 
common form of scrofulous disease. The age at which 
consumption most prevails is from the period of puberty 
to the thirty-fifth year. On the average, the disease 
appears a year and a half earlier in the female than in 
the male sex. The greatest number of deaths occur 
between the ages of 20 and 30. 

Influence of Sex. — "Women are more liable to con- 



906 DISEASES OF THE ORGANS OF BREATHING. 

sumption than men. The difference between the 
sexes, in regard to the number of cases, varies in dif- 
ferent localities. In those communities in which the 
trade and occupations of the men are favorable to its 
development, the disease finds more victims among 
the male than the female sex. It is probably true, as 
has been said, that in the upper ranks of society there 
are more females than males attacked, owing to the 
more impressive variations of dress ; but in the lower 
classes the male patients are more numerous, in con- 
sequence of their more frequent and severe exposure. 

Influence of Inheritance. — This is very marked. The 
disease is largely a hereditary one, being transmitted 
from parents to children, often through many genera- 
tions. "When both parents have died of consumption, 
most life insurance companies will refuse the risk of 
the applicant under thirty-five or forty years of age, no 
matter what the apparent condition of his health. At 
forty, one-half of the danger of the inherited predis- 
position breaking out is said to be passed; and at 
fifty, three-fourths or four-fifths of the danger is gone. 
After sixty, there is little or no doubt but that the 
individual who has escaped thus far will die of some 
other affection, no matter how many of his family may 
have perished from consumption. 

Influence of Climate. — In our article on the distri- 
bution of disease in the United States (see page 638) 
we pointed out that consumption was most fatal in 
New England, where about one-fifth of the inhabitants 
perish from this disease; that in the upper Atlantic 
States, south of New England, the disease is very 



CONSUMPTION OF THE LUNGS. 907 

prevalent, but to a less degree than in the latter dis- 
trict of country, and that as a warmer climate is 
approached the liability to the disease lessens; that 
the Pacific States and territories are no more exempt 
from it than those on the Atlantic coast; that in the 
lofty plateau between the Cascade, Sierra Nevada, and 
Rocky Mountain ranges the disease is almost un- 
known; and that in some parts of the Central States 
there is a less tendency to the disease, on account of 
the dryer condition of the air than near the sea-coast. 
For more particular information in regard to the in- 
fluence of the different climates of the United States 
on this and other diseases, we refer our reader back to 
pages 638 and 657. 

Influence of Occupation. — As Dr. Watson asserts in 
his work on Practice, statistical researches which 
elucidate the influence of different trades and occupa- 
tions in calling consumption into existence are of 
great interest. Much curious information on this 
point has been brought together by Sir James Clark. 
There are certain occupations which appear to pro- 
voke pulmonary consumption by the direct application 
of irritating substances to the lungs themselves. 
There are others which tend indirectly to bring on 
consumption by lowering the tone of the general 
health, by producing debility and a disordered condi- 
tion of the system. These two causes often go together 
in the same occupation, hand in hand, and it is diffi- 
cult to say to which the mischief is most due. The 
workmen whose employments have a directly irritating 
operation upon the respiratory organs are stone- 



908 DISEASES OF THE ORGANS OF BREATHING. 

masons, miners, coal-heavers, flax-dressers, brass and 
steel polishers, metal -grinders, needle-pointers, and 
many others who, of necessity, inhale during their 
labor an atmosphere loaded with irritating particles 
of matter. But then, most of these men work also in 
towns, and remain for many hours, day after day, in a 
bent or constrained position, in a crowded, ill-venti- 
lated, and impure room. Many of these occupations 
being sedentary and requiring no great muscular 
power, are unfortunately selected, on this account, by 
persons who are naturally feeble and delicate. On the 
other hand, butchers, fishermen and their families, and 
farm-servants are said to be comparatively free from 
consumption. This exemption has been ascribed to 
the use of animal food by these classes ; but much of 
their better health is also due, without doubt, to their 
habits of active exercise in the open air, and to the 
circumstance that such employments demand a cer- 
tain amount of bodily strength and vigor, which pre- 
vents their being adopted by weak and scrofulous 
persons. Independently of these sources of fallacy, 
we know beyond all doubt that there are certain occu- 
pations which tend to produce disease of the lungs. 
Thus, the fork-grinders of Sheffield die before they 
are thirty-two years old, of pulmonary complaints. 
Razor-grinders, who, unlike fork-grinders, grind wet 
and dry, live a little longer, the moisture diminishing 
the number of floating particles of the metal. Table- 
knife-grinders work on wet stones, and attain the age 
of forty or fifty. Employments of this nature should, 



CONSUMPTION OF THE LUNGS. 909 

of course, be avoided by all those who inherit or show- 
any tendency to scrofulous diseases. 

Influence of Diet — A scanty and insufficient diet, 
particularly one deficient in fat, is unfavorable for 
those predisposed to consumption. The withdrawal 
of milk, so rich in nutritious elements, from the table 
of children as they approach the age of puberty, it has 
been asserted, on good medical authority, is one of 
the most common causes of consumption. Certainly, 
children and young people should be encouraged to 
take freely at meal -times of fresh milk, than which 
there is no more nutritious fluid known to us. To the 
prevalence at one time in New England of the mis- 
chievous doctrines of vegetarians many cases of 
scrofulous diseases of the lungs have been ascribed. 
The person who has any taint of scrofula in his 
system requires, of all others, a varied and nourishing 
diet. 

IS CONSUMPTION CONTAGIOUS? 

In another work* we have stated that "the bed of a 
consumptive, it is well known, is a powerful source 
of contagion. In Italy it is the custom to destroy, 
after death, the bedel othing of consumptive patients. 
Tubercular disease has, within the past few years, 
been transferred from men to animals by inoculation. 
Authentic cases are upon record of young robust girls, 
of healthy parentage, marrying men affected with 

* The Physical Life of Woman : Advice to the Maiden, Wife, and Mother, 
p. 73. 



910 DISEASES OF THE ORGANS OF BREATHING. 

consumption, acquiring the disease in a short time, 
and dying, in some instances, before their husbands. 
In these significant cases the sickly emanations have 
apparently been communicated during sleep." 

The opinion that consumption is sometimes commu- 
nicated through the influence of contagion is gaining 
ground in the profession. Many physicians still deny 
it • but it is curious to notice that most of those who 
refuse to admit that the disease is at all contagious 
caution their patients and pupils against too much 
and unnecessary exposure. Thus Sir Thomas Watson, 
of England, while asserting that he does not believe 
the affection to be contagious, adds, "I should 
dissuade the occupation of the same bed, or even of 
the same sleeping apartment, by two persons, one of 
whom was known to labor under pulmonary consump- 
tion." Again, Dr. Fuller, while not admitting any 
contagious quality in the disease, says, "It behooves 
the physician to warn the patient's friends of the 
dangers incident to long-continued attendance on him, 
especially if the disease be in an advanced stage. It 
would be the height of imprudence for a healthy 
person, and especially if young and of a scrofulous 
constitution, to sleep in the same bed, or even in the 
same apartment, with a consumptive patient, for, 
although the malady might not be communicated 
directly from one to the other, unless possibly under 
the condition of some tubercular matter being acci- 
dentally introduced into his air-passages or into some 
other part of his system, the surroundings and the air 
would be calculated to predispose him to the disease." 



CONSUMPTION OF THE LUNGS. 911 

Dr. Villemin, the distinguished physician of the H6- 
pital Val-de-Grace, of Paris, suggests "that besides 
the direct transmission, consumption may be con- 
tracted through indirect means, by clothes, bed-linen, 
water-closets, the vitiated air of rooms lived in by 
tuberculous persons, etc. The possible transmissibility 
of the disease in this manner merits the attention of 
medical officers of the army. A consumptive soldier 
dies in the hospital, and his clothes are returned to his 
company and worn by another: may not this be one 
source of consumption in the army ? The barrack is 
to the soldier in the production of consumption what 
the regimental stable is to the horse in the develop- 
ment of farcy, the contagion and transmissibility of 
which are at length accepted." 

The reader has in the above text the opinions of 
some of the most prominent members of the profes- 
sion. He will notice that even those who do not 
accept the belief in the contagion of consumption 
give the same cautions against prolonged exposure to 
the disease as the contagionists do. 

THE MORTALITY OF CONSUMPTION. 

In the temperate zone, where the civilized portions 
of mankind are located, one-tenth of the inhabitants 
die of this malady. It would seem as if the artificial 
habits of civilization developed a tendency to scrofula, 
particularly of the lungs. Among soldiers the dis- 
ease seems to be still more fatal than among civilians. 
It produces nearly one-half of the whole mortality of 



912 DISEASES OF THE ORGANS OF BREATHING. 

the dragoon-guards, England. In our own army, 
during the second year of the late civil war, nine men 
out of every thousand of the mean strength of the 
army died of consumption ; out of every three cases 
of the disease one proved fatal within the year. 
These army returns omit the large number of soldiers 
annually invalided because of scrofulous disease of 
the lungs, the greater part of whom died soon after 
their discharge. In the French army the deaths from 
consumption are rather less than in the British army. 
The mortality from consumption is three times greater 
in our Northern than in our Southern States. 



HOW LONG IT LASTS. 

The ordinary duration of a case of consumption 
varies from six months to two years. It is rare for it 
to prove fatal in less than three months, unless com- 
plicated with severe pleurisy or lung fever. 



THE SYMPTOMS OF CONSUMPTION. 

Of course, it is of the utmost importance to recog- 
nize the presence of this insidious disease as quickly as 
possible. Much attention has of late been directed in 
the profession to the attempt to define and lay down 
rules for the recognition of the precursory or prelimi- 
nary stage — the dawn, as it were, of the disease. In 
some cases this stage is readily to be detected, in 
others it is too brief or too indistinctly marked to be 
observed with any certainty. The symptoms which 



CONSUMPTION OP THE LUNGS. 013 

characterize this preliminary stage are, commonly, 
slow wasting of the bodily vigor, good spirits^ pallid 
or sallow complexion, animated yet careworn expres- 
sion of the features, hurried and anxious movements, 
uncertain appetite, imperfect digestive power, and 
diarrhoea. The sleep is restless, and there is occa- 
sional perspiration at night. Invariably there is loss 
of weight. 

Consumption ordinarily sets in with a short, dry, 
hacking cough, most frequently induced on going to 
bed at night and on rising in the morning. This 
cough may continue for some time without getting 
much worse or without the appearance of any other 
noticeable symptom. It seems at first intended merely 
to clear the throat, where the tickling irritation is felt. 
As the cough increases, at first a scanty and then 
often a copious frothy expectoration occurs, which is 
frequently streaked or stained with blood. In about 
one-half of the cases there is spitting of blood, either 
pure or mixed with the phlegm, and this often gives 
the patient the first unmistakable indication of the 
nature of his trouble. 

Dyspepsia, biliousness, loss of appetite, and head- 
ache are present to a greater or less degree in most 
cases. Among other symptoms, the patient complains 
of languor ; he is easily fatigued, and feels unequal to 
his usual work. He has burning of the soles of the 
feet during the night, and some perspiration. He rises 
in the morning unrefreshed, after having passed a 
restless night. The muscles become flabby, and the 

58 



914 DISEASES OF THE ORGANS OF BREATHING. 

face pale. The pulse is quickened, and beats from 90 
to 140 times in the minute. 

In some cases the nails become curved, prominent in 
the centre, depressed at the sides, crooked and bluish, 
and the ends of the fingers have a peculiar round or 
clubbed appearance. A nail similar to this, however, 
is seen in long-standing heart disease. It is not, there- 
fore, necessarily indicative of consumption. 

A red line around the border of the gums is often 
present. In some patients it is a mere streak, in 
others a twelfth of an inch in breadth. It is not, 
however, a sure sign of the presence of consumption, 
for it is sometimes noticed in persons, particularly 
those with bad teeth, who are unaffected with this 
disease. 

The white of the eye usually becomes of a pearly 
hue, and the pupil is dilated. 

As the disease gradually progresses, the cough 
becomes more frequent and troublesome; the expecto- 
ration increases; the patient is very "short-winded," 
the least extra-exertion in walking exhausts him and 
compels him to stop to recover his breath; hectic 
fever at length appears; the debility increases; chilli- 
ness is complained of in the evening; the patient 
wakes at night or in the morning bathed in a profuse 
perspiration; diarrhoea sets in and increases the 
general feebleness; the lower extremities become 
painful and dropsical; and death closes the scene, 
the mental faculties being usually retained clear and 
unimpaired until nearly the last hour. 

In the language of Dr. Da Costa: "The harassing 



CONSUMPTION OF THE LUN&S. 915 

cough by day and by night; the impaired appetite 
and disturbed digestion; the loss of blood from the 
lungs; the steadily augmenting debility; the short 
breathing; the exhausting night-sweats; the hectic 
fever; the deceptive blush which this imparts to the 
cheek; the increased lustre of the eye; the singular 
hopefulness; the temporary improvements; the re- 
lapses ; and the greater vividness of the imagination, 
so strongly contrasting with the waning frame — are 
phenomena with which sad experience has made not 
only every physician but many a fireside familiar." 



THE PRETENTION OF CONSUMPTION. 

"We have, at some length, in the first part of this 
work, entered into a description of the precautions to 
be observed in order to avoid consumption, by phy- 
sical and mental education, occupation, marriage, and 
certain special courses of action. We need therefore, 
in this connection, only request our reader to refer 
back to page 202. 



THE CURABILITY OF CONSUMPTION. 

Before entering into the details of treatment, we 
have some encouraging words for consumptive pa- 
tients. The general impression is that consumption 
is incurable, that all those affected with it must die. 
This is not correct. It is true that consumption is 
not commonly cured, that most cases terminate 
fatally; but it does not, therefore, follow that the 



916 DISEASES OF THE ORGANS OF BREATHING. 

disease is incurable. On the contrary, the curability of 
the disease is becoming every day more widely recog- 
nized in the profession. It will doubtless always be 
found one of the most fatal of the maladies which afflict 
our race, mainly, however, because the conditions of 
cure are often those with which the patients are unable 
to comply. Dr. Wood, in his work on the Practice of 
Medicine, says on this subject : " I am not one of those 
who believe that consumption is in all cases neces- 
sarily fatal. On the contrary, I believe that, in one 
stage or another, it is occasionally cured, or at least 
ends in perfect recovery. It is no very unfrequent 
event to see threatening symptoms of consumption 
give way under suitable treatment. It cannot be 
proved, with absolute certainty, that those symptoms 
were tuberculous ; because the evidence of dissection 
is wanting, and the physical signs are not sufficiently 
positive, in mild cases of early consumption, to 
authorize a certain conclusion. But they are undis- 
tinguishable from symptoms which, in other cases, 
are the forerunners of confirmed consumption; and 
we have abundant evidence from dissection that 
tubercles are capable of undergoing favorable modifi- 
cations. The probability is that the tuberculous 
matter is absorbed, and sometimes^ as shown by dis- 
section, replaced by calcareous matter; and, if the 
constitutional tendency be so far subdued as to pre- 
vent the deposition of other tubercles, before these 
have completely run their course, the disease may be 
said to be cured. The circumstance that such re- 
mains of tubercles are not unfrequently found in the 



CONSUMPTION OF THE LUNGS. 917 

lungs of old persons, who have died of other diseases, 
would seem to show that these cures are sometimes 
permanent. . 

"But this is not all. It occasionally happens that 
consumptive symptoms disappear entirely even in the 
second stage of the disease, after the formation of a 
cavity in the lungs. This event, it is true, is com- 
paratively rare ; but some cases have probably fallen 
within the notice of almost every practitioner of ex- 
tensive practice. Even should the disease ultimately 
return, still the case may be said to have been cured; 
as the occurrence of a second attack of inflammation 
of the lungs is certainly no proof that the first was 
not cured. But there have been cases in which no 
return of the symptoms has taken place during the 
residue of life, even though considerably protracted. 
Two instances of this kind have occurred in medical 
men of the city of Philadelphia. One of the patients 
was affected, when a young man, with all the symp- 
toms of consumption, including frequent attacks of 
spitting of blood, severe cough, hectic fever, etc., from 
which he completely recovered, and continued exempt 
up to the time of his death, which occurred many 
years afterwards of typhoid fever. The other was my 
preceptor and friend, the late Dr. Joseph Parrish, who 
in early life labored for a time under the symptoms of 
consumption, and after his death, at an advanced age, 
was found to have several cicatrices of the upper part 
of one lung, which were obviously the remains of 
tuberculous cavities. "We may, therefore, always en- 
tertain some hope if applied to in the early stage, in 



918 DISEASES OF THE ORGANS OF BREATHING. 

cases of no great severity, of seeing a cure effected ; 
and even in the second stage, when the constitutional 
taint is not very strong, or the local disease exten- 
sive, there is no reason for absolute despair. Even in 
cases which appear to offer no chance of ultimate re- 
covery, we may hope to be able very much to prolong 
the duration of the complaint, and sometimes even to 
add years to a valuable life. There is an individual 
now pursuing an active business in Philadelphia, 
though with a cavity in his lung, who eight years since 
was under my care with severe cough, copious puru- 
lent expectoration, night-sweats, hectic attacks, and 
great emaciation and debility." 

We could readily adduce additional medical testi- 
mony, were it necessary, as to the curability of con- 
sumption. In our own private and clinical practice 
we have met with a number of cases in which recovery 
from the disease has undoubtedly taken place, and 
others in which, although the patient cannot be said 
to be cured, yet in which life is prolonged and the 
patient able to continue for many years his ordi- 
nary avocation. One business man, at the head of an 
active firm, said to us some time since that he gave 
up his business long ago on account of the condition 
of his lungs, and went home to die ; but getting tired 
of waiting, he resumed his active occupation, and now 
conducts successfully a large trade. The trouble in 
cases of consumption lies not so much in the difficulty 
of cure as in the difficulty of finding a patient both 
able and willing to institute the proper treatment early 
in the affection. 



CONSUMPTION OF THE LUNGS. 919 
THE TREATMENT 

Of consumption consists principally in measures to 
improve the general health by attention to the quan- 
tity and quality of the food, by exercise in the open 
air, by the avoidance of ill-ventilated and close rooms, 
by care of the skin, by warm clothing, by change of 
climate if possible, and by the administration of tonic 
and restorative medicines. 

THE DIET IN CONSUMPTION. 

Consumptive patients require the most nutritious 
food. An animal diet should be taken so long as the 
stomach can digest it. Milk and cream and raw eggs 
are all very nutritious (see receipts on pages 491, 499, 
500, 501, 502, 504). The strong animal broths are of 
great service; among our "Receipts for the Sick 
Table" (p. 490) will be found many useful prepara- 
tions of meats and broths suitable for the consumptive 
patient. 

Dr. Edward Smith, an English physician of great 
experience in the treatment of consumption, gives in 
his work on this disease a bill of fare for the consump- 
tive. This we append, not that it may be scrupulously 
followed, but in order that the suggestions may be 
heeded. 

SCHEME OF DAILY DIET. 

Inasmuch as the strength and vital powers are 
greatly reduced during the night in consumption, it is 



920 DISEASES OF THE ORGANS OF BREATHING. 

of prime importance to supply food to the patient in 
the night as well as in the day. 

1. Immediately on awaking in the early morning, 
half a pint of milk (hot, if possible) alone, or with 
chocolate added, with bread and butter. 

2. For breakfast: three-quarters of a pint of milk, 
with coffee, chocolate, or oatmeal, and eggs or bacon, 
in addition. 

3. At 11 A.M., half a pint of milk, or of good beef- 
tea made from ox heads or shins, with bread and 

butter. 

4. An early dinner, with plenty of meat, and milk 
and egg pudding. 

5. An early tea, consisting of milk, with coffee or 
chocolate, and bread and butter. 

6. An early supper of three-quarters of a pint of 
milk, with oatmeal and chocolate, and bread and 
butter; or two eggs with bread and butter, and milk 
to drink. 

7. During the night, a cup of milk and a little bread 
and butter to be placed by the bedside, and to be eaten 
if the patient should awake. 

By this mode a much larger quantity of food may 
be taken than would be possible if the food were given 
only at the usual meal hour, and as it will be taken 
in small quantities, the system will not be oppressed 
by it, and the vital actions will not be allowed to sub- 
side. It is a dietary which allows a considerable 
quantity of nutritious material to be stored up in the 
system, since it is rich in nutriment. 



CONSUMPTION OF THE LUNGS. 921 



SPECIAL ARTICLES OF FOOD. 

Dr. Smith, the author of the scheme of daily diet 
just given, thinks, with all other physicians who have 
given attention to the subject, that it is of great im- 
portance that there should be a considerable amount 
of fat taken, whatever may be the quantity of vege- 
tables supplied, since it is manifest from common 
experience that the vegetables and greens cannot alone 
meet the requirements of the system.' The dietary 
above given supplies, in the milk ordered, nearly three 
ounces of butter daily, and this added to the butter 
eaten with the bread, would amount to five ounces 
daily. The meat, when well-fed, offers upon the whole 
beast from one-fourth to one-half of weight of fat, so 
that with six ounces of meat we supply about two 
ounces of fat, giving a total daily supply of fat of 
seven ounces. 

The essential consideration in the diet of patients, 
in the early stages of consumption, is an abundance 
of animal and fatty foods, with such an addition of 
bread, vegetables, and the various preparations of grain 
as may be necessary for admixture with the fat. It is 
of prime importance that nutritious food of this char- 
acter shall be supplied early and freely to every pa- 
tient. 

Dr. Edward Smith has, it will be noticed, omitted 
tea as a dietetic article for consumptives, while he has 
recommended the use of coffee and chocolate. This 
he has done because tea possesses the power of in- 
creasing the action of the skin, and whilst there may 



922 DISEASES OE THE ORGANS OE BREATHING. 

be some cases in which this action would not be inju- 
rious, in many instances it would be hurtful. Coffee 
and chocolate, on the contrary, lessen rather than in- 
crease the action of the skin. 

Cream and sugar should enter as largely as possible, 
without exciting disgust or disordering the stomach, 
into the diet of consumptives. Every variety of 
wholesome food pleasant to the patient is to be per- 
mitted, and the appetite and powers of digestion are 
to be encouraged in every way. 

When the appetite fails, or the digestion weakens, 
so that nutritions articles of food cannot be taken, a 
serious obstacle to treatment 'is presented. The pa- 
tient should know, above all things, the importance 
of taking in small quantities at short intervals the 
largest amount of nutriment in the smallest bulk; for, 
upon the nourishment he can take, depends his main 
hope of recovery. He should, therefore, co-operate to 
the best of his ability with nurse and physician in 
their efforts to support him. 

When the powers of digestion of the consumptive 
begin to fail, and when there is soreness of the stomach, 
the use of pepsine with the two principal daily meals 
is to be strongly recommended. 

Pepsine is a powder prepared from rennet bags, the fourth 
stomach of ruminating animals, by washing them, and scrap- 
in o- off the lining membrane and properly treating it. Fifteen 
grains of the powder should be given at the commencement 
of a meal, either between two pieces of bread or in a table- 
spoonful of lukewarm soup. Or, the wine of pepsine may be 
used, of which the dose is a teaspoonful. 



CONSUMPTION OP THE LUNGS. 923 

The addition of a teaspoonful of lime-water to a 
tumblerful of milk will often facilitate its digestion, 
when it would otherwise disagree. 



EXERCISE IN THE OPEN AIR, 

Or out-door life, is of the utmost value in the treat- 
ment of consumption. Prof. Flint considers it of all 
measures the most important. He has published a 
carefully recorded history of sixty-two cases of con- 
sumption in which an arrest of the disease took place. 
In twenty of these, it is stated that the arrest took 
place under hygienic measures without medicinal 
treatment, of which the most important related to 
change of habits in regard to exercise and out-door 
life. In those cases, also, which were treated medi- 
cinally, the improvement corresponded with a greater 
or less change in the habits of life — in relinquishing 
sedentary callings for other more active and open-air 
pursuits. Prof. Flint says: "I would rank exercise 
and out-door life far above any known remedies for the 
cure of the disease. There are grounds for believing 
that the advantage of a change of climate mainly con- 
sists in its being subsidiary to a change of habits as 
regards exercise and out-door life. So deeply im- 
pressed am I with the correctness of this view of the 
regimenal management of the disease, that I cannot 
express myself too emphatically in trying to enforce 
its practical importance. Exercise in the open air 
should be accompanied by either mental recreations or 
occupations which interest the mind. It should, as 



924 DISEASES OF THE ORGANS OF BREATHING. 

far as possible, be incidental to pursuits which engage 
the attention. Adopted simply as a hygienic measure, 
it will rarely be persisted in. It is often essential, 
therefore, for patients to make a radical change in 
business ; or, if they are able to devote their time to 
the restoration of health, hunting, sporting, travelling, 
etc., are to be resorted to as a means of securing the 
union of out-door life with an agreeable exercise of 
the mental faculties." 

It is, indeed, difficult to overrate the benefit to be 
derived from properly regulated recreation and exer- 
cise in the open air. Here again, however, we are 
reminded of the remark which we made at the outset, 
that the difficulty in treating consumption is not in 
the want of efficient remedies, so much as in the 
fact that these remedies are out of the reach of 
most patients. Any one when sick can procure and 
take a medicine (from a free dispensary or hospital if 
necessary), almost every one can procure a proper 
diet, but how few have the time and money to spare 
for months of health-seeking by means of out-door 
pleasures. 'No dispensary or hospital has yet been 
organized which can afford help here. Imperative 
necessity, the calls of business, and the needs of de- 
pendents, stand like barrier- walls between disease and 
cure, and hem the patient in to his own destruction. 



CARE OF THE SKIN. 

The skin must be kept in a good condition. Too 
much attention cannot be paid to this point. Not 



CONSUMPTION OF THE LUNGS. 925 

only should it be kept clean, but groomed. By proper 
bathing and hand-rubbing, or friction with the Turkish 
towel, the blood should be kept to the surface. The 
cold sponge-bath may often be daily taken with 
advantage. It is perfectly safe if it be followed by an 
agreeable glow of the surface. Some patients bear 
well and are much benefited by a cold shower-bath 
daily, followed by brisk friction of the skin with a 
coarse towel. 

WARM CLOTHING. 

The warmth of the body and a healthy state of the 
skin are to be maintained by proper clothing, which 
should not, however, be of such a character as to heat 
the patient uncomfortably or produce perspiration. 
Either woollen or silk vests and drawers are to be 
worn by both sexes; their weight and thickness being 
changed with the season of the year. In cold, 
inclement climates, a waistcoat of chamois or buckskin 
may be worn, by both sexes, over a light undershirt 
of wool or silk. The underclothing worn during the 
day must be removed at night. The bedcovering is 
to be of moderate thickness, and, if possible, increased 
in the early morning. It must not be so abundant as 
to oppress the patient by its weight, or exhaust him 
by the perspiration it occasions. Blankets are much 
to be preferred to heavy counterpanes. The bed should 
not be surrounded by curtains, nor should the patient 
sleep with his head under the covers. 

The feet must at all times be protected against wet 
and cold. For this purpose, boots or shoes with thick 



926 DISEASES OF THE ORGANS OF BREATHING. 

leather or cork soles are much better than rubber 
overshoes. 

CHANGE OF CLIMATE. 

In no disease, probably, is change of climate more 
urgently called for than in consumption. In whatever 
climate the disease breaks out, it proceeds with the 
most rapidity if the patient remains in that country. 
As a rule, consumption is most frequent in low, moist 
situations. The only exception to this is in those 
districts where the temperature is very equable, as on 
the shores of the Mediterranean, and in some parts 
of Florida. The disease is far less prevalent in the 
mountainous parts of all countries than in the lower 
districts. 

Treatment by proper change of climate, when re- 
sorted to sufficiently early in the disease (it is* cruel 
to send away a patient in the last stages, to die away 
from home), produces the happiest results. Something 
more is necessary, however, than a mere removal to a 
healthful place. There are many precautions which 
are to be taken in regard to the care of the health, in 
order to secure the best effects from climatic treatment. 
Information in regard to the kind of climate to be 
chosen, and general directions to be followed by the 
invalid in changing climate, will be found on page 
654 and the ensuing pages. 



CONSUMPTION OF THE LUNGS. 927 

i 
THE MEDICINAL TREATMENT OF CONSUMPTION. 

This, as we have before stated, is less satisfactory 
than the hygienic treatment. There is no specific for 
this disease. Certain medicines, however, judiciously 
administered, can do much for the patient by acting as 
tonics, and thus building up the system, or by relieving 
troublesome symptoms. 

The use of cod-liver oil in this disease is so well 
known that we need not dwell upon it further than to 
say that its reputation is a deserved one. The broivn 
oil is very disagreeable to every one excepting an 
Esquimaux. There is no necessity for using it. Very 
clear, sweet, and scentless forms of the oil may be now 
obtained from good druggists. The dose at first 
should not be more than a teaspoonful, to be gradu- 
ally increased to a tablespoonful twice or three times 
a day. In giving the treatment of scrofula, we men- 
tioned in detail the proper means of administering 
this oil and of disguising its taste. The directions 
there given apply here ; the reader will find them on 
page 794. 

The use of iodine has also been dwelt upon in dis- 
cussing scrofula (see p. 795). This remedy is of as 
great value in consumption, scrofula of the lungs, as 
it is in general scrofula. 

Arsenic is a remedy which may frequently be em- 
ployed with great advantage in cases of slow consump- 
tion. It may be administered in various ways. 
The following is an excellent combination of it with 
iron, recommended by Dr. Da Costa, of Philadelphia: — 



928 DISEASES OF THE ORGANS OF BREATHING. 



Take of— 

Arsenic, one grain. 

Lactate of iron, thirty grains. 

Syrup, sufficient to make a mass. Mix. 
Divide into thirty pills. Take one three times a day. 



Or, the arsenic may be given in the form of granules 
(minute pills). One of these, containing g 1 ^ f a g ra in, 
may be taken just before each meal. Or, Fowler's 
solution of arsenic may be employed, one or two drops 
being taken in water during each meal. 

Extensive professional experience has shown the 
entire harmlessness of arsenic when properly adminis- 
tered (in the doses and manner mentioned). It is 
unquestionably a very effective remedy in certain 
forms of consumption. Nearly every patient who is 
put upon its use shows, within a few days, a marked 
improvement in his general condition; the appetite 
increases, the strength returns, the skin becomes 
clearer and the eye brighter. In about a month, 
when the remedy acts favorably, flesh begins to be 
gained. The best cases for the administration of 
arsenic are those in which there is little fever and no 
severe dyspeptic symptoms. After this medicine is 
used, in the small doses given above, regularly for a 
month or six weeks, it should be stopped for ten days 
or two weeks, and then again resumed ; and the treat- 
ment, with occasional intermissions, thus continued, if 
it prove beneficial, for months. 

The use of natural iron-waters is beneficial in most 
cases of consumption, by the tonic effect produced 
(see p. 645). The waters of the Red Sulphur Spring 



CONSUMPTION" or THE LUNGS. 929 

of Virginia are of service in combating the early 
symptoms of the disease (p. 648). 

Among the Standard Domestic Remedies we have 
recommended, the tonic will be found very valuable 
throughout the whole course of the disease, and the 
expectorant when, from a cold, the cough is more 
troublesome than usual. 

Counter-irritation to the chest is a valuable pro- 
cedure in the early stages of the disease. It is best 
effected by means of croton oil, A mixture of equal 
parts of croton oil and sweet oil may be rubbed on the 
chest, under the collar-bones, every evening until the 
skin is made sore ; and again renewed as soon as the 
eruption and soreness pass away. It is useless to in- 
stitute or persevere in this counter-irritation late in the 
disease, when the patient's strength is exhausted, for it 
is then weakening and annovinp;, and without benefit. 

In the St. George's Hospital, London, the following 
ointment is much employed instead of croton oil: — 



Take of— 

Calomel, eight grains. 

Iodine, thirty grains. 

Alcohol, one and one-half fluidrachm. 

Fresh lard, one ounce. Mix. 



Of this a portion is to be rubbed in over the affected 
lung morning and evening until an eruption comes 
out upon the skin. 

Some physicians employ as a counter-irritant, instead 
of either of the above applications, a solution of lunar 
caustic (nitrate of silver) of the strength of thirty 

59 



930 DISEASES OF THE ORGANS OF BREATHING. 

grains to the ounce of distilled or rain water. The 
skin of the chest under the collar-bone is to be well 
painted with this every evening until it becomes of a 
dark-brown or black color. This application is to be 
made evening after evening until the scarfskin peels 
off. 

THE RELIEF OF THE COUGH. 

Cough mixtures, as a rule, should be taken sparingly. 
It is a great mistake to constantly dose a consumptive 
patient with some pulmonary syrup or expectorant 
remedy. Besides doing little or no good, these 
mixtures disorder the stomach, and thus prevent the 
patient from taking food, upon which all his hopes 
of recovery depend. Nevertheless, occasionally the 
cough is so irritating and constant that it demands 
attention, for the frequently recurring attacks of 
coughing themselves destroy the digestive powers and 
induce nausea. Every patient should remember, 
however, that much of this superfluous coughing can 
be checked by his own efforts, that the habit of 
unnecessary attempts at expectoration is, to a con- 
siderable extent, under voluntary control. The patient 
should resist the inclination to cough whenever it is 
not required to get rid of phlegm actually present. 
An excellent soothing mixture when the cough is 
troublesome is the following, which any druggist can 
put up : — 





CONSUMPTION OE THE LUNGS. 


931 




Take of— 
Laudanum, half a fluidrachm. 
Fluid extract of wild cherry, 
Syrup of gum arabic, of each, two fluidounces. 




Of this a teaspoonful should be taken several times 
in the day when the cough is most troublesome. The 
laudanum may be omitted from the recipe if desired ; 
it is in such a small dose that there is little danger of 
its affecting at all the appetite. 

TO CHECK THE NIGHT-SWEATS. 

These are often annoying and exhausting. Often 
the following mixture will be found very efficacious 
for their relief, as well as for the soothing of the 
cough : — 




Take of— 

Dilute sulphuric acid, two fmidrachnis. 

Fluid extract of wild cherry, two fluidounces. Mix. 
Dose a teaspoonful three or four times a day. 




Bat! 

equal 

bay-ru 

the sti 

remed 

ounce 

water, 

is also 


ling the skin in the evening with a mixt 
parts of good cider-vinegar and water, o 
m and water, or a solution of alum and wz 
*ength of a teaspoonful to the pint, are all 
Les. Sage-tea (made of the strength of h 
of dried leaves of sage to a quart of b 
with lemon and sugar added) taken at bee 
a useful preventive. 


are of 
r with 
iter of 
useful 
alf an 
oiling 
Itime, 



932 DISEASES OF THE ORGANS OF BREATHING. 



TO STOP BLEEDING FROM THE LUNGS. 

Most consumptive patients have sooner or later an 
attack of hemorrhage from the lungs of greater or less 
severity, which alarms themselves and their friends. 
There is really, however, comparatively little danger 
of the patient bleeding to death from this cause. It 
is very rare for the hemorrhage to be so excessive as 
to cause death. The patient may, and often does, 
become so exhausted by the loss of blood that his 
death is hastened by it. Hence the importance of 
checking as soon as possible hemorrhage from the 
lungs. 

There is one remedy which is perfectly safe, and 
very nigh infallible in these cases. No patient, liable 
to such attacks, should be without it in his pockets ; 
no family, of which a member is ill of this disease, 
should neglect to have the remedy at hand. This 
remedy is gallic acid. It should be obtained from the 
druggist, put up in powders of twenty grains each, and 
at least ten of these powders should always be kept 
ready for immediate use in an emergency. One should 
be given every five or ten minutes until the bleeding 
ceases. "We repeat, there is no danger of any sort in 
the free administration of this preparation, and that 
it is the most effective as well as the safest remedy 
known. 

Common salt is often employed in domestic practice 
for checking hemorrhage from the lungs. It should 
be given dry, in the dose of a teaspoonful. Turpen- 



CONSUMPTION OF THE LUNGS. 933 

tine is also of service in ten-drop doses every ten min- 
utes. 

When there is no actual hemorrhage, but frequently 
repeated spitting of blood, or staining of the expec- 
toration with it, the following pills will be found use- 
ful to control the circulation within the lungs, and 
check the tendency to bleeding: — 



Take of— 

Sulphate of copper, seven grains. 

Sulphate of iron, two scruples. 

Extract of henbane, one scruple. Mix. 
Divide into twenty pills, and take one three times a 
day. 



"When there is a tendency to repeated attacks of 
hemorrhage or spitting of blood, cod-liver oil, if it is 
being administered, should be suspended for a while 
until this tendency, by the use of the above pills for 
about ten days, is gotten rid of. 

TO CHECK THE DIARRHOEA. 

When the consumptive patient is troubled by a 
looseness of the bowels, a flannel bandage should be 
worn around the abdomen, and powders of the subni- 
trate of bismuth given, fifteen grains three times a day. 
The diarrhoea which comes on in the latter stages 
of the disease it is diflicult, and often impossible, to 
check or relieve. 

We have now gone over, with some minuteness and 
care, the treatment of consumption. We have endeav- 
ored to call the attention of the reader to the impor- 



934 DISEASES OF THE ORGANS OE BREATHING. 

tance of early measures for its relief, and to impress 
upon him that such measures, judiciously chosen and 
faithfully followed out, offer a fair prospect of cure. 
"We have also endeavored to induce him to place more 
reliance upon hygienic remedies, change of climate, 
exercise in the open air, a generous diet, and a careful 
supervision of the condition of the skin, than upon 
drugs, while we have not failed to point out the value 
of many of the latter for the relief of troublesome 
symptoms and the restoration of enfeebled powers. 
Above all, it has been our aim to bring into promi- 
nence prevention rather than cure. 





CHAPTEK VIII. 

DISEASES OF THE HEART. 

CONTENTS. 

Enlargement of the Heabt. Causes of enlarged heart — The symptoms 
— The treatment by diet, by rest, by medicines. 

The Blue Disease. Its nature — The symptoms — The mortality of the dis- 
ease — The treatment 

ENLARGEMENT OF THE HEART. 

HE proper size of the heart may be roughly- 
stated at about that of the closed fist. In the 
adult male, the average weight is about nine and a 
half ounces; in the adult female, about eight and a 
half ounces. The heart naturally increases in weight 
somewhat after the age of sixty. 

When the heart, from any cause, becomes much 
larger than the above-mentioned size, the patient has 
enlargement of the heart, or, in medical language, hy- 
pertrophy of the heart. 

CAUSES OF ENLARGED HEART. 

The heart is a muscle, a hollow muscle. Like all 
other muscles of the body, it increases in size if its 

( 935 ) 



936 DISEASES OF THE HEART. 

exercise be increased. We have all seen in the arm 
of the blacksmith the effect of exercise upon the mus- 
cles. Every gymnast knows that if he regularly calls 
into play for a while any series of muscles, that, even 
in a few weeks, they will augment in volume as well 
as power. This is also true of the heart. Whatever, 
therefore, leads to increased action of the heart, tends 
to enlarge it. Hence excessive and prolonged physi- 
cal exertion, like that of the professional rower and 
prize-fighter, is one of the causes of this disease. But 
it is most commonly met with, probably, after attacks 
of rheumatism. We have pointed out, in treating of 
that disease, the importance of so treating it as to 
avoid any heart affection. It is more common among 
males than females. Soldiers during our late war were 
very frequently affected with it in consequence of the 
strain of long and forced marches. 

THE SYMPTOMS OF ENLARGED HEART. 

The eyes are bright, and often prominent; the lips 
and eyelids are apt to be unduly red. The pulse is 
full and strong. The large vessels at the sides of the 
neck beat forcibly under the influence of the least un- 
wonted excitement or exertion. Often there are head- 
ache and giddiness, ringing in the ears, rush of blood 
to the head, and shortness of breath. The action of 
the heart is sometimes so forcible as to attract the 
patient's attention, and alarm him while lying in bed. 
In a few instances there is a dry cough, which may 



ENLARGEMENT OF THE HEART. 937 

lead to the belief that there is threatened consump- 
tion. 

THE TREATMENT. 

The cause of the disease should be detected, and, if 
possible, avoided. The gymnast should cease his 
forced feats of strength, which are the cause of the 
mischief; the rower should abandon his boat exercise. 
In some cases the use of coffee deranges the action of 
the heart. This, however, is rare. Cases are met 
with in which, from a peculiarity of constitution or 
from excessive use of this ordinarily harmless and 
restorative drink, palpitation and enlargement of the 
central organ of circulation ensue. In a case re- 
cently under our professional charge, a young lady 
had produced palpitation of the heart, which would 
doubtless have shortly led to enlargement, by her 
habit of drinking at each meal several large cups of 
very strong coffee. When the coffee was prohibited, 
the trouble passed away. Tobacco, in some few indi- 
viduals, also disorders the heart's actions. Such per- 
sons should, of course, give up the use of the weed 
altogether and in every form. 

As a medicine, there is nothing of greater value in 
subduing the violent throbbing of the heart than 
aconite. It must, however, be given in small doses, 
and its administration kept up persistently for many 
months. One drop of the tincture of aconite should 
be given twice a day until the action of the heart be- 
comes softer and less forcible. The dose may then be 
reduced to a drop once a day, and continued for a year 



938 DISEASES OF THE HEART. 

if necessary. In these doses there is no danger from 
the use of this remedy, and its beneficial effects are 
very marked. 

The diet must be unstimulating. Animal food is to 
be permitted, especially if the patient is pale and 
feeble. But no alcoholic liquors are to be allowed, 
and the patient should limit, as much as possible, the 
quantity of fluids which he drinks. 

The wearing of a belladonna plaster over the heart 
will be found useful. 

No immediate effects are to be hoped for from the 
above treatment, nor are they to be sought for. Any 
attempts to suddenly lessen the heart's action are 
dangerous. But a patient perseverance in the above 
line of treatment for months or years will prevent any 
further increase of the disease, and gradually tone 
down the force and reduce the size of the affected 
organ. 

The patient is, of course, to guard himself as much 
as he can against any exciting emotions, and to avoid 
all violent muscular exertions — whatever, in fact, dis- 
turbs the heart and produces an attack of palpitation. 

A milk diet, if strictly adhered to, will in many 
cases afford much relief to persons affected with heart 
disease. Under the influence of this diet the impulse 
of the heart diminishes, together with the palpitation 
and the congested condition of the lips and eyelids; 
the dizziness and ringing in the ears also gradually 
disappear. The patient experiences unexpected im- 
provement even in very severe cases, and by the 



ENLARGEMENT OF THE HEART. 939 

adoption of this plan life may be prolonged in those 
instances where a permanent cure cannot be hoped for. 
When dropsy appears in consequence of disease of 
the heart, diuretics are to be resorted to. For this 
purpose a powder consisting of ten gains of nitre and 
half a grain of squills may be given three times a 
day. Or, instead of squills, a teaspoonful of cream of 
tartar may be mixed with the ten-grain powder of 
nitre, and taken two or three times a day. 



940 DISEASES OF THE HEART. 



The Blue Disease. 



Occasionally a child is born the whole surface of 
whose body is of a deep blue or purple color. It is 
then said to have " the blue disease." Ordinarily this 
condition appears at birth or is first noticed a very 
short time after. It sometimes comes on later in life. 
It has been noticed after an attack of cholera, after 
great physical exertion, particularly in a young per- 
son, and after an attack of rheumatic fever. 

This disease is due to a malformation of the valves 
of the heart, which permits of a mixture of the blue 
venous blood with the red arterial blood. This malfor- 
mation usually exists at birth, though it may in rare 
instances be induced by the causes just mentioned. 

The discoloration of the skin differs greatly in dif- 
ferent cases. Sometimes the color is very slight, in 
others it is so dark as to approach blackness. Every 
part of the body is affected. But certain portions, for 
instance, around the eyes, the ears, the cheeks, the 
lips, the end of the nose, and the roots of the finger- 
nails, present a discoloration deeper than elsewhere. 
The degree of the blueness varies in the same case at 
different times. Thus, fits of coughing, excessive exer- 
cise, mental emotion, and whatever excites the action 
of the heart, increase its intensity. Indeed, in mild 
cases, the blueness may not be noticed excepting 
when the system is under the influence of one of these 
circumstances; when the heart is perfectly tranquil, 
it may be entirely absent. 



THE BLUE DISEASE. 



941 



THE MORTALITY OF THE DISEASE. 

This affection is a very fatal one. If the case be 
at all severe, life is rarely prolonged more than a few 
years ; when the disease is less marked, the patient 
may live to middle life. One hundred and eighty-six 
cases of blue disease have lately been collected and 
their histories recorded. Of these, 67, or more than 
one-third, died in the first year of life, nearly a half of 
them in the first week ; 121, or more than three-fifths, 
failed to reach the tenth year of age; only 24 survived 
twenty years of age, and but four of them reached the 
fortieth year. In one case on record, life was pro- 
longed for fifty-seven years. 

Many of the children affected with blue disease die 
in early infancy from hoopiug-cough or some other 
disease of childhood, for they resist badly an attack 
of any prevailing malady. Many die of convulsions 
and from suffocation. 

Patients who long survive their birth suffer greatly 
from coldness of the body, palpitation of the heart, 
attacks of difficulty of breathing, and often faint on 
the least excitement. The ends of the fingers and 
toes become enlarged, bulbous-like, and the nails are 
curved. 

Throughout life, the muscular and the mental 
powers are both deficient, and the unhappy patient is 
shut out to a great extent from the world of pleasure 
and usefulness. 

Males are more liable to blue disease than females. 



942 DISEASES OF THE HEART. 

The reason of this difference between the sexes is not 
known. 

THE TREATMENT 

Of blue disease is necessarily palliative rather than 
curative. It has for its object to relieve the most 
troublesome symptoms, to give to the patient the 
greatest amount of comfort possible for him, and to 
avert threatened death; it cannot hope to effect a 
radical cure. 

The diet should be nourishing, the clothing warm, 
the climate mild, the mind tranquil, and the physical 
powers untasked. The patient must avoid all expo- 
sures to severe cold, and support his strength when 
required by tonics. 

When an attack of difficulty of breathing and 
threatened suffocation comes on, the proper treatment 
is the internal administration of Hoffmann's anodyne 
or some other stimulant, the application of mustard 
plasters to the chest, and the immersion of the feet in 
a mustard bath. 

It has been recommended that young children af- 
flicted with this disease should be placed on the right 
side upon a pillow raised to an angle of about forty- 
five degrees. This position seems to relieve the blue- 
ness of the surface, and to add to the ease and comfort 
of the child. Its beneficial effects are due to the fact 
that in this posture the heart's action is freer and more 
unincumbered. 



THE BLUE DISEASE. 943 

When the veins of the legs are enlarged and tor- 
turous, laced stockings should be worn. 

Attention to the above details will give the sufferers 
from blue disease the best chances for life and happi- 
ness that medical science can afford them. 





CHAPTEE IX. 



DISEASES OF THE ORGANS OF DIGESTION. 



CONTENTS. 



Choleka. Its fatal character — Definition of the disease — Where and how 
it originates — The manner in which it travels from country to country — 
Circumstances which predispose an individual to an attack — Is it conta- 
gious ? — How to prevent it — The symptoms of cholera — The treatment. 

Dyspepsia. The causes — Avoidable causes: eating too much; eating too 
little ; sedentary habits ; solitude ; improper use of purgative drugs ; tight- 
lacing ; the abuses of alcohol, tea, tobacco, and opium — Unavoidable causes 
— The symptoms of dyspepsia — The treatment : by diet ; by medicine, 
home remedies, and drugs — Heartburn, its causes and treatment — Sour 
stomach, causes and treatment — Flatulency, causes and treatment — Pains 
in the stomach — Value of mineral springs for dyspeptics. 

Constipation of the Bowels. The causes of constipated bowels: the 
abuse of purgative medicines; indolent habits; neglect of nature's calls; 
errors in diet ; old age — The treatment : by hygienic means, movements, 
diet, use of water, exercise, mineral springs, and home remedies. 

Diarrhoea or Looseness. Definition — The cause of diarrhoea — Its mor- 
tality — How to treat it — Chronic diarrhoea and its treatment. 

Dysentery or Bloody Flux. Difference between diarrhoea and dysentery 
— The fatal character of dysentery when epidemic — The causes — The 
symptoms — The treatment. 

Liver Complaints. The obscure and difficult character of diseases of the 
liver — Jaundice — The meaning of the name — The symptoms of jaundice — 
The causes — The treatment. 



( 944 ) 



CHOLERA. 945 



CHOLERA. 




HIS disease has been justly described as the 
most fatal known in the annals of medicine. 
The cholera poison is one 

"Whose effect 
Holds such an enmity with blood of man, 
That, swift as quicksilver, it courses through 
The natural gates and alleys of the body • 
And, with a sudden vigor it doth posset 
And curd, like eager droppings into milk, 
The thin and wholesome blood." 

Such is its overwhelming effect upon the patient, 
that it is known at Bagdad under the name of 
Haouwa, which means tornado. It is also called 
malignant cholera, epidemic cholera, and Asiatic 
cholera, terms which denote its severity and origin. 



DEFINITION. 

Cholera is a disease developed under certain con- 
ditions of the air and soil, and capable of being spread 
abroad, from country to country, by means of the at- 
mosphere and of human intercourse between the healthy 
and sick. The symptoms are, in most instances, a fore- 
running diarrhoea, painless and watery in character; 
sudden loss of strength; tremblings of the body 
and limbs; swimming in the head; nausea and vomit- 
ing ; pain in the bowels ; difficulty of breathing, and 
a feeling of faintness; loss of voice; coldness and 
dampness of the whole surface of the body, and cold 

60 



946 DISEASES OF THE ORGANS OF DIGESTION. 

breath; cramps and restlessness; intense thirst; blue- 
ness of the skin, and a sunken and appalling counte- 
nance ; and a peculiar odor from the body. These 
symptoms terminate in death in from fifteen minutes 
to a few days ; in recovery, in from twelve hours to a 
week or two. 



ORIGIN OF THE DISEASE. 

Cholera is of eastern origin. It probably existed in 
India for a long time, but the first migratory epidemic 
appeared at Jessore in 1817; it devastated Calcutta, 
and decimated the grand army of the Marquis of 
Hastings. In 1831 it was imported into the north of 
Europe, into England, and on the 8th of June into our 
own country. It visited us by way of Quebec. On 
the week after its arrival it appeared at Montreal, and 
within the month at New York and Albany. The 
first cases appeared in Philadelphia in July, and in 
Boston and Baltimore in August. Before September, 
1832, it had entered twelve different States of the 
Union. Charleston, South Carolina, did not suffer from 
it until 1836. It appeared to die out in the United 
States in 1837, and remained absent for about twelve 
years. The second visit to this country by the disease 
was paid in the year 1849, having come from Europe, 
where it prevailed during 1848-49. It lingered in 
many places in Europe and the United States from 
1850 to 1854. The Western States suffered the most ; 
it seemed specially to cling about military stations 
and emigrants' camps. During this period, the 



CHOLERA. 947 

disease did not prevail with any violence until 1853. 
The years 1853 and 1854 were cholera years in both 
continents. In the spring of 1866 it appeared in New 
York and spread over the country. 

In these epidemics, the disease attacked the poor in 
a larger proportion than the rich, showing that desti- 
tution, filth, and foul air have much to do with its 
appearance and stay. 



CIRCUMSTANCES WHICH PREDISPOSE TO THE DISEASE. 

All ages, even the new-born, are liable to the affec- 
tion. The mortality is least from six years to twenty, 
and greatest in old age. The Registrar-General of 
England shows, in regard to the influence of sex, that 
more males suffer from the disease than females under 
the age of twenty-five ; but between twenty-five and 
forty-five the females suffered more than the males. 
In Canada, the soldiers' wives were observed to suffer 
nearly in an equal proportion with their husbands. 
In all countries and in every city it has been observed 
that the lower and poverty-stricken classes (par- 
ticularly those resident on the banks of rivers) are 
attacked very much more generally than the upper 
and weathier classes. A poor diet also predisposes to 
cholera. Thus it is well known in India that the 
European suffers less than the Mohammedan, who in 
turn suffers less than the worse fed and clothed Hin- 
doo. During the rigid religious fasts of the Moham- 
medans they are more liable to it than at other times. 



948 DISEASES OF THE ORGANS OF DIGESTION. 
IS IT CONTAGIOUS? 

The contagious character of cholera has been called 
in question. We think that the evidence as to its 
contagiousness is conclusive. It is communicated in 
many instances from one person to another. The 
characteristic rice-water discharges from the bowels 
of the patient are instrumental, as has been well 
pointed out by Dr. Budd, in transmitting the poison 
of the disease to other and uninfected persons in the 
following principal ways : — 

1. By the soiled hands of attendants -on the sick, a 
mode of communication probably very common within 
the limits of the family circle. 

2. By means of bed and body linen, and other 
articles tainted with the rice-water discharges. 

3. Through the medium of the soil. The discharges 
being liquid, the great bulk of them find their way to 
the ground, from which the poison may be propagated 
in these ways : (a) By rising into the air as a product 
of evaporation ; (b) By percolating into the drinking 
water ; (c) By diffusion in the atmosphere in the form 
of impalpable dust, after it has passed into the dried 
state. 

"While we are forced to the belief in the conta- 
giousness of cholera, we fully indorse the opinion of 
an eminent authority, that "if proper precautions are 
taken where it is present, there is scarcely any risk 
that the disease will spread to persons who nurse and 
otherwise closely attend upon the sick. But it is not the 
less true that all matters which the patient discharges 



CHOLERA. 949 

from the stomach and bowels are infective ; that the 
patient's power of infecting other persons is due 
entirely, or almost entirely, to these discharges ; that 
these, however, are comparatively non-infective when 
first discharged, but afterwards, while undergoing 
decomposition, acquire their maximum of infective 
power ; that, if cast away without previous disinfec- 
tion, they impart their own infective quality to other 
excremental matters ; that if they get access, even in 
the smallest quantity, to wells or other sources of 
drinking water, they may infect very large volumes 
of water; but the infective influence of choleraic 
discharges attaches to whatever bedding, clothing, 
towels, and like things have been imbued with them ; 
and that thus even a single case of cholera may exert 
a terrible power over large masses of population, if 
local circumstances co-operate. 

The disease may be communicated by the premoni- 
tory diarrhoea. 

Tli e prevention of cholera was discussed in the first 
part of this book, when treating of the avoidance of 
special diseases (see p. 258). We there pointed out the 
personal precautions necessary, the preventive treat- 
ment, the specific preventives, and the general pre- 
ventive measures which should be observed by every 
household. "We need scarcely add to these directions. 
As, however, the disease is eminently a preventable 
one, and we wish to impress certain precautions upon 
the mind of our reader, we will here, at the risk of some 
repetition, give a number of rules for general con- 
duct when the cholera is epidemic. They are based 



950 DISEASES OF THE ORGANS OF DIGESTION. 

upon the regulations adopted by a number of the 
sanitary committees and boards of health of the large 
cities in this country and in England during the pre- 
valence of the later epidemics of the disease. 

1. Observe strict cleanliness of person, clothing, and 
house. Be regular in all the habits of life, in morals, 
meals, exercise, and sleep. 

2. Do not be afraid of cholera, nor make it the 
topic of conversation. Fear and all the depressing 
passions are injurious. 

3. Do not take brandy; it is not a preventive, and 
it may do harm by disordering the action of the 
bowels and stomach. 

4. Do not make any change in the usual diet, if it 
be simple and of easy digestion. Eat moderately, 
and at regular intervals, as long fasting is injurious. 
Carefully avoid excess in any intoxicating beverage. 

5. Avoid excessive bodily fatigue and mental exhaus- 
tion. If overheated, beware of any sudden chill, and 
see that the skin is kept comfortably warm. If the 
disease appears in winter, much benefit may be derived 
from wearing a flannel belt around the body, covering 
the stomach and bowels. 

6. Check any diarrhoea, even the slightest, which 
may occur, by immediate and perfect rest in bed, a 
careful diet, and the administration of laxatives, as 
advised on page 261. 

7. Remain in bed two or three days after the diar- 
rhoea is checked. The patient, no matter how well he 
may feel, must obey this rule. (For other directions, 
see pp. 258-265.) 



CHOLERA. 951 



THE SYMPTOMS OF CHOLERA. 

The disease usually shows itself in three stages. 
The first is characterized by diarrhoea and vomiting, 
which may be looked upon as efforts of nature to ex- 
pel the poison from the blood. The second stage is 
denoted by the setting in also of cramps, spasms, and 
coldness of the body. The third stage is one of sink- 
ing or collapse. "We have given in detail the symp- 
toms on page 945. 

TREATMENT. 

The early or premonitory diarrhoea should be treated 
by rest in bed, regulated diet, and laxatives, as just 
mentioned. This diarrhoea should not be neglected 
even for an hour. 

There must be plenty of fresh air in the sick-room. 
No dry heat should be applied to the person of the 
patient, but clothes moistened with hot water may be 
applied, or warm moist blankets thrown about him. 
It is important to keep the surface of the body moist. 
Even after the temperature is restored, tepid sponging 
should be kept up, or the wet sheet used. The cruel 
practice, which formerly prevailed, of denying the 
patient the cold water which he so eagerly craves to 
quench his intense thirst, is not to be imitated. Let 
him drink as freely as he will of pure and cold water, 
even if a considerable portion be at once poured off by 
the bowels. The blood is in a thick, dried state, owing 
to the rapid escape by means of the watery discharges, 



952 DISEASES OF THE ORGANS OE DIGESTION. 

of its fluid constituents, and the desire of the patient 
for water is a natural and physiological one. Ice may 
be allowed freely, not only to dissolve in the mouth, 
but to swallow in small pieces. 

The following drink has been recommended as one 
which is generally relished and retained upon the 
stomach : — 



Take a raw Egg, and beat it up with half a pint of 
Milk. Mix with about a pint and a half of water, and 
add as much salt as will give the whole an agreeable 
taste. 



Milk and water, whey, or weak chicken-broth may 
be taken freely. Injections of warm milk, frequently 
repeated, are of much value in relieving the pains and 
improving the condition of the blood. 

In the second stage of the disease, a powder con- 
sisting of twenty grains of common salt, thirty grains 
of carbonate of soda, and seven grains of chlorate of 
potash, given in water every half hour, will be of ser- 
vice, together with the application of a large mustard 
plaster over the stomach. Of course, the chances of 
success, when the disease has passed into this stage, 
are much less than when it is yet in the first stage. 

In the third stage, that of collapse, when marked, 
there is little hope. Friction with warm towels, and 
an injection by the bowels of the above-recommended 
powder of salt, soda, and potash, may be employed. 

"When the patient begins to recover, the secretions 
from the kidneys must be looked after. If he do not 
pass water, a teaspoonful of sweet spirits of nitre with 



CHOLERA. 



953 



ten grains of acetate of potash should be frequently 
given in a half tumbler of water, until the desired 
effect on the kidneys is produced. 

The greatest precaution also should be taken during 
convalescence in regard to the diet. The too early 
use of animal food has caused not a few deaths of 
cholera patients. Broths and like fluid preparations 
should, as a rule, alone be allowed until the secretion 
from the kidneys is fully restored and all the symp- 
toms of the disease have disappeared. 

Stimulants of all kinds tend to inflate the stomach, 
and are of no use; other than hot coffee or peppermint 
tea, few or none are to be allowed. 

The host of remedial agents of a most opposite, 
useless, and often positively injurious kind, recom- 
mended in the daily papers during cholera times, are 
to be disregarded. These communications ordinarily 
show merely the weakness, ignorance, and credulity 
of the writers. 

All violent remedies are to be avoided in the treat- 
ment of this disease. Strychnia, prussic acid, large 
doses of calomel or lead, tobacco, electricity, bags of 
ice to the spine, injections of spirits, etc., are alike 
detrimental. Nature effects a cure by slowly re- 
establishing the natural constitution of the blood, 
which none of these remedies can at all hasten. 



954 diseases of the organs of digestion. 

Dyspepsia. 

Dyspepsia, or difficulty of digestion, is, in American 
life, a very common disease. It consists in a disturb- 
ance of the stomach and digestive powers, without any 
other affection ; or, if other diseases exist, they are of 
minor importance. 

the causes 

Of dyspepsia are numerous. Anything which inter- 
feres with the action of the stomach or intestines tends 
to produce it. 

AVOIDABLE CAUSES. 

Prominent among the causes of dyspepsia are 
certain social habits, which we shall pass in review. 
It is the more important to consider them, as they are 
influences which it is in the power of the individual 
to avoid or modify. They are usually persisted in 
through ignorance, hence we hope that some informa- 
tion on the subject may lead to a reform, which is the 
first step towards a cure of the dyspeptic disorders 
to which they may have given rise. 

JUating too Much. — The habitual use of food in too 
large quantity is a cause of dyspepsia not as common 
with us as with Europeans. An occasional excess at 
the table is not productive of so much mischief— the 
"remorse of a guilty stomach" is usually its only 
punishment. But persistent gluttony, a daily over- 
indulgence in the pleasures of the table, brings with it 



DYSPEPSIA. 955 

all the discomforts and pains of dyspepsia. This 
excess in eating is without excuse. Looking at it 
from the point of pleasure only, it is a mistake. The 
true epicure finds his greatest enjoyment in temperate 
indulgence ; it is the quality and not the quantity of 
jwhat he eats which affords gratification to his palate. 

Dyspepsia does not always prevent the heavy eater 
from increasing in flesh. In some cases it is asso- 
ciated with a loss in weight, but in many others the 
gourmand goes on adding to his corpulence while he 
is suffering from the torments of painful digestion. 

Headache is one of the common symptoms which 
accompany excess in diet. The patient also complains 
of a sense of fulness or repletion, want of sleep at 
night, feverishness in the morning, irregularity of the 
bowels, and depression of spirits. The remedy for this 
state of affairs, caused by eating too much, can be 
given in one word — "don't." 

Eating too Little. — Those who eat too little for their 
stomach's welfare are not confined altogether to those 
unfortunates who have too little to eat. This error in 
diet often arises from mistaken views in regard to 
health. A person has pain after eating, due perhaps 
to improper cooking, and concludes that an abstinence 
from meats is the panacea. A student, or professional 
or business man, weakens his brain and taxes his 
stomach by irregular hours of eating, badly prepared 
food, and the refusal to give sufficient time to his 
meals, and then listens to the pernicious counsel of some 
hobbyist that his indigestion is due to too much eat- 
ing. He, therefore, seeks a remedy in vegetarianism 



956 DISEASES OF THE ORGANS OF DIGESTION. 

or a restricted diet, and so undermines his general 
health and increases his dyspeptic troubles. Again, 
from false notions of religious duty, undue abstinence 
from food is practised, together with a self-denial of 
all those innocent arts of the cuisine which render 
food pleasant, and give thereby a fillip to digestion. 
In the language of Dr. Chambers, we would say: 
"Surely this is stoicism or Gnosticism, rather than 
the religion of the Bible. I am not fond of preaching, 
especially to clergymen, or of turning texts into traps ; 
but people should not forget the threatening at the 
end of Ecclesiastes, where we are told that God will 
bring us to judgment, and make us account for our 
unused opportunities of enjoyment, for not being cheer- 
ful in our youth, and loving the beautiful ; and where 
we are urged on these grounds to ' remove sorrow from 
thy heart, and put away evil from thy flesh.' Forget- 
fulness in youth of the Creator and His creatures, 
disregard of the Giver as exhibited in his gifts, and 
neglecting to render Him thanks by using them, always 
entail a punishment on either mind or body. A joy- 
less man becomes an unhealthy man; in body, if they 
are bodily joys that he has foregone; in mind, if they 
are mental." 

Among American women, in particular, the fault of 
eating too little is quite a common one. It should be 
remembered that food is the natural stimulant of the 
stomach, just as light is of the eye, and that if it be 
deprived of a proper amount of food the stomach will 
become weak and disordered for the same reason that 



DYSPEPSIA. 957 

the eyes when continually exposed to complete or 
partial darkness become impaired and finally blind. 

Sedentary habits are doubtless often blamed un- 
justly for that dyspepsia which is due to other causes. 
The English physician, from whom we have just 
quoted, in an excellent treatise on this subject, very 
judiciously says: "Among the originators of dys- 
pepsia we commonly find included in books sedentary 
habits. But when I come to look over my notes, I 
cannot extract any cases which would exhibit this 
fact. I do not know by experience if a sedentary life, 
such as that of a clerk or book-keeper for example, 
would induce the defect unless it were joined to some 
other cause. Alone, with a properly regulated diet, it 
seems consistent with quite healthy digestive powers. 
We find it so in the bedridden under our care, whose 
life may be viewed as the type of a sedentary one, 
yet they do not suffer except from some more than 
ordinary folly in diet or from the misuse of some 
drug. When, therefore, those who come before us for 
indigestion attribute their state to a sedentary life, we 
must not stop there, but search further for other and 
more certain causes. For example, the editor of a 
weekly newspaper, aged about forty, laid on the many 
hours he spent in the office chair the blame of the dys- 
pepsia which spoilt his night's rest by waking him in 
the early morning by flatulence. Charcoal gave him 
only temporary relief, but dividing his meals more 
(instead of a breakfast, and hearty dinner in the 
evening) seems to have set him up completely. Let 
it not be supposed that I underrate the value to health 



958 DISEASES OF THE ORGANS OF DIGESTION. 

of exercise in the open air. The fresh oxygen, the 
cheerful occupation, the distraction of the mind from 
injurious tension, must, however, be taken into account 
by the physiologist, and not all the benefit set down 
to muscular motion, which latter element is but a 
small part of what is usually included under the 
recommendation of exercise by a rational physician. 
I have come across more brain laborers whose diges- 
tion has been injured by injudicious excess in muscular 
exertion than by the reverse. Let not those whose 
avocations are necessarily sedentary, despair of finding 
by judicious experiment a mode of passing their lives 
in complete, though not of course blooming health. 
The division and arrangement of the meals according 
to the mode of life is a very important part of the 
science of digesting them." 

Solitude. — Eating alone, or what is equivalent to 
the same thing, in the solitude of a crowded hotel 
table, is often productive, directly or indirectly, of 
disorders of the digestive apparatus. Directly, it 
does harm by the removal of that stimulus to diges- 
tion found in pleasant social converse, which distin- 
guishes the eating of men from the feeding of animals. 
Indirectly, it does harm by leading to the habits of 
hurrying through a meal without proper mastication 
of the food. Every meal, if possible, should be taken 
in the company of friends and intimates, and the 
conversation should be cheerful. Merriment is an 
excellent condiment. 

Improper Use of Purgative Drugs. — There are some 
persons in the community who are constantly dosing 



DYSPEPSIA. 959 

themselves, and urging others to take purgative me- 
dicines. A habit is thus quickly formed, and the 
bowels cease to act excepting under the influence of 
medicine. Of course, the constant employment of 
cathartics soon disorders the digestion. The remedy 
for the dyspepsia, under these circumstances, is the 
gradual withdrawal of the customary drugs. Cold 
water injections are an admirable aid in the breaking 
up of this bad habit. As soon as the bowels begin to 
act spontaneously, they in turn should be gradually 
abandoned. 

Tight-lacing. — It is said of Hiram Powers, the 
celebrated sculptor, that one evening in Rome, when 
in an assembly of beauty and fashion, his attention 
was called to a face of uncommon beauty. "Face," 
said the sculptor, after a short silence, "that is all very 

well, but I want to know where Lady puts her 

liver." Isot only the liver, but the unresisting stomach, 
suffers from being dragged and pushed out of position 
by the pressure of the tightly-drawn stays. We can 
readily show the agency of tight-lacing in inducing 
dyspepsia in many cases, but when we come to insist 
upon the remedy, w T e have usually found in our prac- 
tice that women have on this point, as has been aptly 
said, "a very strong won't." 

The abuses of alcohol, of tea, of tobacco, and of 
opium are causes of dyspepsia in not a few instances. 
Either of these causes is usually readily detected, and 
its power of removal in the hands of the patient. 



960 DISEASES OF THE ORGANS OF DIGESTION. 



CAUSES OF DYSPEPSIA, TO A GREAT EXTENT, 
UNAVOIDABLE. 

The habits of social life, which we have just enume- 
rated, make quite an array of avoidable causes which 
lead to dyspeptic troubles. There are certain other 
influences which produce the same effect, but which 
are not, as a rule, under the control of the individual. 

Among these we may mention mental anxiety, 
caused by business reverses or family misfortunes; 
poverty, because of the insufficient food it is alone 
able to furnish; excessive physical or intellectual 
labor, under the pressure of necessity; general de- 
bility; impurity of the blood, due to the poison of 
fever or cholera; and disease of the lungs, brain, or 
liver. Under the influence of either of these causes 
we may have indigestion produced. In such a case 
it is not so much the patient's fault as his misfortune. 
But when he has brought his troubles upon himself 
by any of the social habits we have mentioned, he is 
to be blamed rather than pitied. 

The nervous irritability, so frequently remarked in 
literary and scientific men, has its origin in most in- 
stances in dyspepsia, the cause of which may fre- 
quently be traced to an avoidable habit. To all such 
we commend Bacon's suggestion, "that we make ap- 
plication of our knowledge to give ourselves repose 
and contentment, and not distaste or repining." 



DYSPEPSIA. 961 



THE SYMPTOMS OF DYSPEPSIA. 

One of the most uniform and prominent symptoms 
is loss or irregularity of the appetite. Associated 
with this, there is a feeling of pain or weight and ful- 
ness at the pit of the stomach after meals. Sometimes 
nausea and even vomiting may be present. There is 
usually flatulence or an excessive amount of gas in the 
bowels. The tongue is foul, and there is a bad taste in 
the mouth. The bowels are constipated at one time, and 
there is diarrhoea at another. The spirits are usually 
low, and there is marked mental and physical languor. 
The breath is often offensive, and the body loses flesh. 
In some quite exceptional cases the appetite continues 
good, and even becomes ravenous, while the patient 
becomes fatter. There are often a dull headache, and 
pains in the loins and limbs. 

THE TREATMENT 

Of dyspepsia is said to be an easy and successful one, 
provided the patients have the ability and willingness 
to follow a few simple rules. "Fling but a stone, and 
the giant dies." Often, however, the task of cure 
will be found, in practice, a difficult one. 

On this subject, the professor of practice in the 
Jefferson Medical College says: "Unfortunately, a 
very large majority of our patients are incapable, how- 
ever well convinced, of following our advice (as to 
exercise and temperance), and of the few remaining, 
more than a moiety would turn a deaf ear to our ex- 

61 



962 DISEASES OF THE ORGANS OF DIGESTION. 



hortations. The student will not set a limit to the 
acquisition of knowledge, though made, as he is but 
too conscious, at the expense of his health, and ulti- 
mately of his very life. The idle sensualist cannot 
be spurred to exertion, but prefers the indulgence of 
his contemptible sluggishness. The poor artist and 
mechanic, though writhing under the pressure of pain 
and infirmity, cannot remit exertions on which depend 
their means of daily subsistence. Nor have we yet 
learned to "minister to a mind diseased," to calm the 
tumults of passion, to soothe into tranquillity the 
grief of the mourner and the anxious fears of the 
distressed. We must, then, be content to palliate 
evils which we have not the power to shun or take 
away; and this, in truth, constitutes the purpose of 
medical practice in dyspepsia. To the student we 
must prescribe hours of exercise; to the glutton, 
measured intervals and quantities of food; to the 
voluptuary, rules for the government of his headlong 
appetites; otherwise the continued application of the 
causes which have produced will perpetuate or renew 
the disease, in spite of all our remedies. 

" The dyspeptic, then, should sleep on a hard, firm 
mattress, rather than an ordinary featherbed, should 
avoid late vigils, and arise moderately early. • His 
breakfast should be a light one, and taken soon after 
rising, to fit him for his accustomed exercise or occu- 
pation. He should enjoy free access to the open 
air, and shun all close and ill- ventilated apartments. 
If urged by appetite or prompted by an uneasy feel- 
ing of hollowness at the stomach, or debility, he may 



DYSPEPSIA. 963 

take a little nourishment at or about noon. His 
dinner should be moderate, and rather an early than a 
late one. If he can, he should follow the old maxim, 
4 After dinner rest a while;' yet, unless specially 
feeble, I would not encourage any indulgence in the 
recumbent posture or in sleep. The question as to 
the propriety of taking supper has been warmly 
discussed ; but the answer seems to me an easy one. 
If there has been bodily labor or active exercise after 
dinner, a slight meal should be allowed, otherwise not. 

"The term exercise comprises a variety of modes, 
all of which tend to the same purpose. Frictions 
over the whole cutaneous surface, but particularly the 
abdomen, do much good by exciting the vessels and 
disposing to perspiration. If the bowels be pressed 
and kneaded, it is said to arouse their peristaltic 
action and relieve constipation. This was Halsted's 
method of treating dyspeptics, at one time so famous 
in New York. Playing with the dumb-bells, swing- 
ing, leaping the rope, fencing, and other gymnastics, 
should be resorted to in bad weather. Riding in a 
carriage and sailing are of great service ; but horse- 
back exercise is probably most beneficial to the 
majority." 

It was a remark of Dr. Abernethy that no person 
could be persuaded to pay attention to his digestive 
organs until death or the dread of death was staring 
him in the face. The regulation of the diet which 
alone will often effect a cure is therefore a matter 
difficult to enforce. Those errors of eating too much 
and of eating too little should be equally given up. 



964 DISEASES OF THE ORGANS OF DIGESTION. 

The abuse of tobacco, alcohol, tea, and opium must be 
abandoned, and the other avoidable causes of dyspepsia, 
which we have enumerated, avoided. The food must 
be masticated thoroughly, in order that it may go into 
the stomach in a finely divided state and well mixed 
with the secretions of the mouth. In regard to the 
character of the food, whatever is found to habitually 
disagree should be shunned; there must be, however, 
an abundant variety in the diet; and everything should 
be properly cooked. The ignorant cook, so frequently 
found in our American kitchens, has ruined many 
stomachs for her employers. 

The diet should be one easy of digestion, and the 
powers of digestion improved by those means which 
strengthen the system generally. In very severe cases 
the stomach may be allowed complete rest and the 
patient nourished for twenty-four hours by means of 
nutritious injections (see p. 514). 

THE MEDICINAL TREATMENT 

Of dyspepsia consists in the administration of those 
remedies which are known to facilitate digestion or to 
relieve the pain of indigestion. 

One of the best remedies, particularly when there is 
difficulty in digesting animal food, is pepsine. This is 
the digestive principle of the gastric juice. The 
symptoms which call for its administration are imper- 
fect or slow digestion, wind in the bowels, sour belch- 
ings, nausea, low spirits, and general languor. The 
proper time for taking it is at the commencement of a 



DYSPEPSIA. 965 

meal. Fifteen grains of the powder may then be 
given between two pieces of bread or in a little sonp. 
The dose of the wine of pepsine is a teaspoonful. 

"When the stomach is not very irritable, vegetable 
tonics are valuable. Huxham's tincture of bark, in 
teaspoonful doses three times a day, will be found use- 
ful. So also will the American poplar (see p. 726). 
The tonic of the Standard Domestic Remedies is of 
great service in many of these cases. 

Vichy and the German or Saratoga Seltzer water 
are beneficial in obstinate cases in which there is 
sourness of the stomach. 

As hygienic means of cure, the movements described 
on page 670 are to be recommended in some cases. 

"White mustard seeds afford relief in some instances, 
particularly where there is much constipation. They 
are not to be broken, but a tablespoonful mingled 
whole with molasses and taken once a day. 

A cupful of water taken as hot as it can be drunk 
is of considerable benefit when there is a sensation of 
coldness at the stomach. 

An acid preparation combined with pepsine is an 
excellent prescription when the stomach does not 
secrete a proper amount of gastric juice. 



Take of— 

Nitro -muriatic acid, two fluidrachms. 
Wine of pepsine, three fluidounces. Mix. 



The dose of this recipe is a teaspoonful three times 
a day, just before or after meals. When there is 



966 DISEASES OF THE ORGANS OF DIGESTION. 

troublesome constipation the following pills may be 
taken at the same time: — 



Take of— 




Powdered rhubarb, 


one scruple. 


Quinine, ten grains 


Mix. 


Divide into ten pills. 





Take one of these pills every night, and, if neces- 
sary to produce a laxative effect, one also in the 
morning. "While following out this treatment, the 
diet should be nearly an exclusively meat one, all 
vegetable substances being partaken of sparingly. 

The treatment of heartburn, water-brash, sour 
stomach, flatulence, and pain in the stomach, all 
symptoms of dyspepsia, we will mention under the 
head of each. 

HEARTBURN. 

Heartburn is a feeling of heat or cold, usually the 
former, experienced after food has been taken, in the 
upper portion and towards the left of the pit of the 
stomach, and running at intervals up the course of the 
gullet. It often resembles the sensation produced by 
swallowing something very hot. The time at which 
it appears varies. Sometimes it comes on in fifteen 
minutes after a meal, in other instances, or at other 
times in the same individual, it is deferred as long as 
three hours. The heartburn which is complained of 
before food is taken is the postponed heartburn caused 
by the last meal. 



DYSPEPSIA. 967 

One kind of food often brings it on as much as any 
other, and it is frequently worse after the earlier meals 
of the day than the later. It comes on suddenly, and 
often disappears as quickly. 

The causes of heartburn are harassing mental 
emotions, over-anxiety, watching, pressure over the 
stomach (therefore common among shoemakers, seam- 
stresses, clerks, and others whose ordinary occupations 
involve pressure upon the pit of the stomach), general 
debility, and improper food. 

The treatment of heartburn consists, in the first 
place, in the removal of the cause of the trouble. 
Sponging the body with cold sea-water, and the use 
of the shower-bath, are strongly to be recommended. 
Often great advantage is derived from the cold 
sponging or douching of the belly, which may readily 
be done while sitting in a hip-bath. This treatment 
should be followed up with the administration of the 
tonic in the list of the Standard Domestic Remedies. 

In some cases the juice of a lemon affords relief; in 
others a dose of lime-water or a teaspoonful of baking 
soda, in a wineglassful of water, taken immediately 
after meals. A quarter of a teaspoonful of calcined 
magnesia is also a useful palliative. 

WATER-BRASH. 

Water-brash consists in raising into the mouth a 
burning, sour fluid. It is very apt to be associated 
with heartburn. 



968 DISEASES OF THE ORGANS OF DIGESTION. 

The use of the following powders will be produc- 
tive of great benefit: — 



Take of— 

Bicarbonate of soda (baking soda), two drachms 
Subnitrate of bismuth, three drachms. Mix. 

Divide into 12 powders. 



One of these powders is to be taken after each meal. 
The rectified oil of amber is also a most excellent 
remedy : — 



Take of— 






Rectified oil of amber, 


two fluidrachms. 


Gum-Arabic mixture, 


two and 


a half fluidounces. 


Mix. 







A teaspoonful after meals. 

SOUK STOMACH. 

For sourness of the stomach the prescription of 
soda and bismuth just given is of value. Lime-water 
in doses of a teaspoonful, and calcined magnesia in 
doses of a quarter of a teaspoonful, afford relief. 
These remedies, in order to be of permanent benefit, 
must be combined with a course of tonic treatment 
directed to the improvement of the general health. 

FLATULENCY. 

This is a very troublesome complication of dys- 
pepsia. In bad cases, after each meal, independently 



DYSPEPSIA. 969 

of its quantity or character, the bowels are distended 
with air, much to the annoyance of the sufferer. 

A plaster of assafcetida worn over the stomach is 
an efficacious remedy. A dessertspoonful of willow 
charcoal after each meal usually affords prompt relief, 
by virtue of the gas-absorbent property of the char- 
coal. A very pleasant way of taking this remedy is 
to have it inclosed in gelatine capsules, each of which 
contains ten grains of the heavy vegetable ivory 
charcoal. Of these capsules two are the ordinary 
dose. They may be had of many apothecaries. 

Immediate relief is often found from the taMng of 
from three to five drops of cajeput oil, and repeating 
the dose after a short interval ; or from the essence of 
peppermint, in the dose of ten or twenty drops. 

PAIN LN" THE STOMACH. 

Sensations like "being blown out with wind," or 
feelings of tightness or weight, are sometimes com- 
plained of, when, upon examination, the stomach is not 
found at all distended. These feelings often attend an 
exhausted condition of the stomach, produced by men- 
tal annoyances, too severe and protracted labor, and 
whatever strains the nervous forces of the system. 

Of course, the remedy for this state of things con- 
sists in a restoration of the general health. The cure 
is a matter of hygiene rather than of medicine. 

When a wearing or boring pain is complained of, 
increased by pressure upon the stomach, and aggra- 
vated by food, then there is probably some disease of 



970 DISEASES OF THE ORGANS OF DIGESTION. 

the coats of the stomach. Then counter-irritation 
over the stomach by means of mustard plasters or 
blisters, and the internal use of subnitrate of bismuth 
in doses of twenty grains three times a day, are re- 
quired. In addition, the stomach must be spared as 
much as possible. A mixture of equal parts of lime- 
water and milk, in small quantities at short intervals, 
affords much nourishment without disturbing the 
failing organ by calling upon it for any exertion. A 
nicely broiled mutton-chop may often be eaten in these 
cases without pain, if preceded by fifteen grains of 
pepsine. 



THE VALUE OF MINERAL SPRINGS FOR DYSPEPTICS. 

The various symptoms of dyspepsia, which we have 
just enumerated, are all more or less benefited by the 
use of the natural mineral-waters, when these are 
judiciously chosen and properly taken. 

" To the dyspeptic, perhaps, more than others among 
the numerous sufferers from chronic disease," says 
Prof. Dickson, of Philadelphia, "the various medi- 
cinal springs, diffused over all regions of the globe, 
are valuable and useful. Of these there are two 
classes from which he may derive special advantage, 
the chalybeate (iron) and the mildly purgative. Both 
these appear to have their remedial virtues much 
heightened by impregnation with carbonic acid, a 
chemical agent, fatal when introduced into the lungs, 
but grateful and pleasantly stimulating to the stomach. 
Common water, indeed, with which this gas has been 



DYSPEPSIA. 971 

combined by forcible pressure (soda-water), is highly 
agreeable to most persons, and will often relieve irri- 
tability of the stomach, remove nausea, and check 
vomiting. The Seltzer and Saratoga waters form an 
innocent luxury for the sound, while they benefit, nay, 
entirely restore, the otherwise hopelessly sick. These 
natural formulas we imitate in vain; in vain we com- 
bine the agents which chemical analysis has detected 
in their composition. It has been made a question, 
concerning which I feel much indifference, whether the 
benefits obtained at the various watering-places, so 
much and so beneficially resorted to, are derived from 
the specific virtues of the crystal well, or by the mere 
mechanical washing out, or by the exercise and agree- 
able society which in such resorts entice and amuse 
the invalid. I say I care not whether the restoration 
of health and comfort is brought about in either of 
these modes, or, as I am disposed to think, by means 
of them all collectively. It suffices to know that a 
few weeks' or months 5 residence at, and proper use of, 
these hygeian streams has often given new life to the 
despairing dyspeptic; and that many a wretch, brought 
to their healing fountains a mass of disease, misery, 
and despondency, has returned home with a frame 
glowing with ruddy health, and a mind bright with 

cheerful anticipations." 

We need not repeat here what we have said upon page 
643 and the ensuing pages in regard to the value of 
the different springs, and the proper manner of using 
their waters. In concluding our counsels to the dys- 
peptic, we would advise all, who fail to be benefited by 



972 DISEASES OF THE ORGANS OF DIGESTION. 

other means, to resort to some appropriate natural 
spring before despairing of recovery. 

As prevention is much better than cure, we trust 
the reader who happily is yet free from any of the 
forms of dyspepsia, will not neglect to peruse our re- 
marks on the prevention of indigestion and dyspepsia 
on page 269. 



constipation of the bowels. 973 

Constipation of the Bowels. 

This subject is an important one. Many evils 
result from constipated bowels. There is no trouble 
more generally, perhaps, brought on by the imprudent 
disregard of natural laws than this. The sufferer has 
himself to blame in most instances; upon his own 
shoulders rests the responsibility for the long train of 
consequences which follows costiveness. "We shall 
aim, therefore, in pointing out in detail the causes of 
this affection, to indicate the means of prevention as 
well as of cure. 

THE CAUSES OF CONSTIPATED BOWELS. 

One of the most common of these is the abuse of 
purgative medicines. The injudicious habit is wide- 
spread, especially among women, of more or less 
constantly resorting to opening medicines. 

Action and reaction are always equal in the human 
system as well as out of it. If, therefore, the bowels 
be excited to undue action by a cathartic, such action 
will be succeeded by undue depression, calling again 
for the administration of the cathartic. It seems like 
a very easy and a perfectly proper thing to get rid of 
a constipated habit by taking purgative drugs. This 
impression is confirmed by the immediate effects of a 
dose of opening medicine, as the patient for a brief 
period after its action feels much lighter and freer. 
But what are the after-effects? It is found that there 
is a tendency to increase of constipation in a short 



974 DISEASES OF THE ORGANS OF DIGESTION. 

time, accompanied with an unpleasant feeling of ful- 
ness of the bowels, with inability to obtain relief in 
the ordinary way. The natural powers of the bowels 
have been weakened by the undue stimulation to 
which they have been subjected by the purgative; 
they need a certain amount of rest, and cannot resume 
the even tenor of their course at once. Either this rest 
must be allowed, which is as imperatively demanded 
as sleep by the overwrought brain, or another dose of 
the purgative must be taken. Most people will choose 
the latter expedient, and seek for relief again by that 
which benefited them, although temporarily, before. 
Repetition of the doses of purgative medicines only 
increases the troubles and augments the demand for 
more, until finally obstinate constipation becomes 
established. 

The constipation being thus confirmed, the patients 
hope to cure it by means of purgatives. The attempt 
is of course a vain one. This abuse of purgatives is 
ascribed by an English physician to the notion which 
seems to be entertained by not a few persons, that 
medicine is a necessity of existence. Those affected 
with this monomania at length hardly feel happy 
without their daily pill, powder, or draft. It becomes 
with them an all-absorbing idea, implanted in their 
very nature, that they cannot preserve health without 
physic. 

We especially wish to condemn the practice of 
giving frequently and unnecessarily purgatives to 
infants and young children. Ill-advised mothers 
may readily in this manner, with the kindest inten- 



CONSTIPATION OF THE BOWELS. 975 

tions, lay the foundation in their young charges of 
a permanently constipated habit, which the best- 
directed efforts in after life may fail to remove or 
modify. The misery which may result from such a 
condition of the system established in infancy is very 
great. 



INDOLENT HABITS A CAUSE OF CONSTIPATION. 

No one can with impunity spend most of his or her 
time, without exercise, in a close, hot, ill -ventilated 
room. A life made up of undue self-indulgence, 
indolent habits, too much sleep, confinement in badly 
ventilated and heated rooms, varied only by the 
exercise which can be had by riding in a close carriage 
and occasionally stepping out to pay a visit or make 
a purchase, will be one necessarily characterized by 
great delicacy and susceptibility to the slightest 
external impressions, by incapability for any bodily 
effort, by diminution of intellectual vigor, by imperfect 
digestion, and by torpor of the bowels. Yet this mode 
of life is frequently led in our large cities by those 
whose pecuniary condition renders unnecessary for 
their support any physical or mental labor. And, 
singular to relate, these invalids attribute their ill- 
health to an infliction of Providence. To such we 
commend the following utterances of a medical 
moralist: "Grant that a certain proportion of sickness 
must ever be unavoidable: still it remains an indispu- 
table fact that much of ill-health is self-derived; and 
it is certainly an injustice done to our God, when evils 



976 DISEASES OF THE ORGANS OF DIGESTION. 

resulting entirely from our own infringement of His 
perfect laws are reflected off ourselves and thrown upon 
Him. Such injustice is flagrant enough, even in the 
absence of a full acquaintance with the errors which 
may originate and retain ill-health; but how inexcusa- 
ble it is to plead thus in extenuation of our own faulty 
habits, when such habits have been knowingly and 
persistently indulged in, contrary to the dictates of 
reason, common sense, and competent advice! Self- 
deception is too common a sin, and a very plausible 
one. "When the wish is father to the thought, there 
exists an aptitude to reason upon false premises." 

NEGLECT OF NATURE'S CALLS. 

The habitual neglect of proper periods for evacu- 
ating the bowels, especially when nature impels, is a 
frequent cause of constipation. There are many 
excuses for this neglect. The man of business 
alleges want of time, as he hurries away immediately 
after breakfast to his store or counting-house. This 
thoughtless custom of leaving home so soon as the 
breakfast is swallowed, without attending to a little 
duty which by practice might soon become a useful 
habit, leads to hurtful results because of the frequent 
absence of convenience just at the right time during 
the day, as well as through the influence of little diffi- 
culties of a social character added to pressure upon 
business time. This evil, trifling as it may appear, 
inflicts often serious injury before the sufferer opens 
his eyes to the gravity of the fact. 



CONSTIPATION OF THE BOWELS. 977 

"We would not be understood to insist upon the 
after-breakfast period arbitrarily, for, as an English 
writer on this topic has justly insisted, a too eager 
desire of the mind for an instant response to a volun- 
tary solicitation (fearing the loss of only a few minutes 
of valuable time) defeats the object in view. The im- 
patient brain concentrates on itself, and renders nuga- 
tory all efforts. But to carry out systematically either 
the morning rule or the evening rule, is without doubt 
of no little importance to most persons. Every one 
has probably experienced practically the ill conse- 
quences of resisting the natural impulse, in unpleasant 
weight and distension of the bowels, and ineffective 
efforts at obtaining relief before bedtime ; followed, 
perhaps, by an uneasy night of tossing about in bed 
and unpleasant dreams. The involuntary solicitations 
of the bowels cannot be ignored with entire impunity 
even by healthy persons, much less by those who are 
predisposed to irregularities of the bowels. 

Besides the constipation which follows a daily and 
repeated neglect of the natural solicitations, a serious 
consequence is to be dreaded. The morbid matters 
thus retained in the intestinal canal may be absorbed 
into the blood, and poison the whole system. Often 
gastric fever and bilious attacks with great prostra- 
tion, and typhoid symptoms, may be traced to the 
frequent repetition of this unfortunate opposition to 
the natural impulse. 

These remarks are not to be understood as confined 
to the male sex, whose business engagements tend to 
produce negligence in regard to the bowels. The evil 

63 



978 DISEASES OF THE ORGANS OF DIGESTION. 

also exists among those of the other sex, whose time 
is to a considerable extent under their own control. 
They neglect the sudden natural impulse "to save 
themselves the trouble of immediately rising from a 
comfortable position in an easy-chair or on a sofa ; or 
to avoid the little self-denial demanded in instantly 
relinquishing the pleasure of an interesting novel, 
absorbing paragraph in the newspaper, agreeable con- 
versation with a friend, letter- writing, or other matters 
comparatively trifling when placed in opposition to 
the performance of a natural call, which (however 
disagreeable the idea), if not at once responded to, 
may not again be possible on that day. Sometimes a 
feeling of modesty, lest sudden departure for a few 
minutes from society should be noticed as remarkable, 
presents itself as another barrier, and when we are 
compelled to throw out a delicate hint on this point, 
we are met by the rejoinder, 'I cannot attend to the 
call for appearance's sake.' But all little difficulties 
will melt away before a little firmness, tact, and self- 
possession. The duty should always be looked upon 
as a necessary one ; and the self-imposed task of re- 
taining within and carrying about fetid accumula- 
tions should be regarded in the most revolting 
possible aspect, all minor feelings and contingencies 
yielding. Superadded to this, let there be some sub- 
stantial measure of reflection upon the ulterior conse- 
quences of the self-promotion of intestinal irregularity: 
which disagreeable consequences, under various phe- 
nomena and modifications (according to temperament, 



CONSTIPATION OF THE BOWELS. 979 

constitution, and collateral circumstances), will surely 
arise, if the neglect be permitted to become habitual." 

OTHER CAUSES OF CONSTIPATION. 

There are numerous other causes than those we have 
just enumerated. Errors of the table, in partaking of 
a too monotonous, too drying, too stimulating, or too 
highly concentrated food, often cause costiveness. 
Overdone meat and hard-boiled eggs, and a deficiency 
of fruit and vegetables in the daily diet- are frequently 
to blame. Certain mechanical obstructions in the 
bowels sometimes exist, such as the impaction of 
cherry-stones, seeds of fruit, pieces of bones, and like 
hard and indigestible substances which are swallowed. 
Piles and rheumatic affections occasionally interfere 
with the free action of the bowels. In old age there 
is a natural tendency to torpidity of the bowels, par- 
ticularly when, on account of decrepitude, there is 
little or no exercise taken. Certain nervous affections 
lead directly to constipation by interfering with the 
supply of the nervous force or fluid to the muscular 
coat of the intestines. 

"Whatever the cause of the constipation, it is apt to 
be associated with low spirits, disordered appetite, of- 
fensive breath, coated tongue, and a dingy complexion 
with dark lines under the eyes. The patient ordina- 
rily soon loses all disposition to active exertion; he is 
troubled with headache and palpitation of the heart, 
and frequently with neuralgic pains. 



980 DISEASES OF THE ORGANS OF DIGESTION. 
THE TREATMENT 

Of constipation is ordinarily not difficult if the cause 
can be recognized and removed. 

A person whose bowels cease to be moved in the 
manner natural to him should at once direct his atten- 
tion to the discovery of the reason of the change. In 
regard to the number of evacuations which may be 
considered natural, each individual is a rule, as it were, 
to himself. Most people have an evacuation in health 
once a day. There are some with whom it has always 
been the rule to go to stool twice a day, and some 
only once every second or third day. Whatever has 
been the habit in this respect is the rule of health to 
each person, and any variation from it is indicative of 
some disorder. 

In the cure of constipation, the great aim in view is 
to do away with the use of purgative drugs. This 
cannot be effected at once. A gradual substitution of 
milder purgatives for the more active ones which have 
been employed should be sought for. For this pur- 
pose, sweet oil, in doses of a tablespoonful at bedtime 
or an hour before dinner, Seidlitz powders, or Congress 
water, may be employed in the place of the more 
powerful cathartic pills or powders which have been 
resorted to by the patient. There is no remedy, how- 
ever, which will prove of more benefit than the free 
use of cold water injections. 

The following movements are often effectual in cases 
of habitual constipation. They may be performed by 
the patient upon himself: — 



CONSTIPATION OF THE BOWELS. 981 

Place the tips of the fingers of the right hand over 
the point of the belly at which a line drawn from the 
centre of the front surface of the thigh up towards 
the right ribs would be crossed by a line extending 
around from the umbilicus. This point will be over 
the large bowel as it runs upwards to make its turn 
under the borders of the right ribs to pass across the 
abdomen, and turn downwards under the borders of 
the left ribs. Pressure is to be made at this point 
very lightly. The fingers are then to be carried up 
along the ascending bowel to the lower borders of the 
ribs of the right side, thence, without any intermission, 
directly across to the lower borders of the ribs of the 
left side, and then downwards in the course of the 
bowel to the left groin. The fingers must now be 
pressed firmly into the belly at this latter point, and 
retained there for fifteen seconds. The hand is then 
to be removed altogether for a few seconds, when the 
procedure is to be repeated. The operation may be 
kept up for a period of from a few minutes to a 
quarter of an hour or more. If the ends of the fingers 
be dry and harsh, they should be moistened. When 
the right hand is tired, the left can be used, and so 
alternately, but it is better not to alternate them too 
rapidly. The patient may first try, and may succeed 
or not. If there be a failure, the attempt must not be 
abandoned. Invalids themselves will often fail, almost 
invariably if their bowels be extremely intractable. 
But now the aid of a friend to institute these move- 
ments may be invaluable. 

"Whatever mode of treatment be employed for con- 



982 DISEASES OF THE ORGANS OF DIGESTION. 

stipation, it will be comparatively futile if attention 
be not paid to the regulation of the diet. The food 
must be wholesome, varied, and digestible. Vegeta- 
bles, excepting the coarser varieties which produce 
wind colic, are beneficial. Ripe fruits taken in the 
morning are always pleasant and very useful. Figs 
and prunes, oatmeal porridge for breakfast, and bran 
bread, are well-known laxative articles. 

Dr. Tanner says: "There are very few cases' of 
costiveness with dyspepsia, arising from sedentary 
pursuits, that may not be cured by the sufferer retiring 
to bed at eleven o'clock, and drinking a tumblerful of 
spring- water ; rising at seven in the morning and 
taking a bottle of soda-water; then walking for three- 
quarters of an hour; and afterwards breakfasting upon 
weak tea with plenty of milk, and meat, bread, etc." 

Of course, the bad habits which have led to the 
costiveness must be avoided before relief can be 
hoped for from any remedial measures. 

The free use of cold water, taken beyond the 
demands of thirst, several times a day between meals, 
is a most efficient remedy. "Water externally applied 
is also serviceable. The warm hip-bath and the cold 
sponge salt-bath, preceded and followed by brisk 
rubbing of the skin, are very valuable remedies. 
Even persons with cold hands and feet, and a weak 
pulse, can bear to be sponged with salt-water, and will 
be benefited by it. The application to the abdomen at 
night of a few folds of thin flannel or calico, wrung 
out in warm water, and covered with oiled silk, paper, 



COXSTIPATION OP THE BOWELS. 983 

or muslin, will be attended with marked advantage, 
especially when there is disorder of the liver. 

The bowels should be solicited to act at a regu- 
lar hour of the day, preferably just after breakfast. 
Exercise each day in the open air, on foot or horse- 
back, should be regularly taken. A tumbler of cold 
water drunk about two hours after a meal, and fol- 
lowed by a walk or a little sharp exercise of any kind, 
will be found an excellent expedient in some instances. 
The regular use of common salt at every meal is often 
of essential service. 

An English physician recommends, in case out- 
door exercise cannot be had sufficiently often, at least 
twice a day, that "a pair of light dumb-bells or clubs, 
or a skipping-rope, should be regular articles of bed- 
room or dressing-room furniture, and should be used 
every morning on rising (after swallowing a glass of 
cold water) and before the usual matutinal ablution. 
The gymnasium, when approved of and easily accessi- 
ble, may be highly useful, and an excellent practice 
consists in raising up the body and legs by means of 
the hands grasping a cross pole or rope just within 
reach. Thus we strengthen the abdominal muscles 
and promote their more powerful contraction upon the 
intestines. Rowing in a boat, or an imitation of it in 
the gymnasium, is very advantageous. Horse exercise 
is, when convenient, an excellent auxiliary for the 
relief of this kind of constipation, particularly for 
the physically weak, whose previous habits have 
unfitted them for brisk walking exercise. But walking 
and riding will be most advantageously used in alter- 



984 DISEASES OF THE ORGANS OF DIGESTION. 

nation. As with walking, so with riding, motion 
should always be rapid while it lasts, but each period 
of exercise should be sufficiently limited in duration 
to guard against subsequent lassitude or fatigue." 

In the treatment of the constipation of old age 
nothing is of so much value as a daily walk or ride. 
The use of oily articles of food, such as butter, bacon, 
etc., also alleviates the costiveness. The sexagena- 
rian should remember, however, that it is not natural 
for him to have the same activity of the bowels as he 
had in early youth. A daily evacuation, which is the 
rule in early and mature Jife, may be set down as an 
excess in an old man, still more in an old woman. A 
movement every other day is all that need be desired 
or looked for in perfect health in advanced life. 

The use of the water of Anderson's spring at 
Bedford, Pennsylvania, is often very beneficial in cases 
of obstinate constipation. The same remark is true 
of several of the Saratoga springs. 

The movements employed in "the movement cure" 
for constipation are described on page 668. 

A tea made of white walnut (p. 733) or of dande- 
lion (p. 736) may be employed with advantage. 



DIAEEHCEA. 985 

DlAEEHCEA OE LOOSENESS. 

Diarrhoea is a disease in which the evacuations 
from the bowels are frequent and loose. There is also 
usually a furred tongue, impaired appetite, and, when 
the discharges are abundant and long continued, loss 
of strength and flesh. 

THE CAUSES 

Of diarrhoea are quite numerous. The most common 
of all is a fault in the food, which is either of improper 
quantity or quality. Whenever food which in itself 
is perfectly unirritating is undigested from any cause, 
as, for instance, weakness of the stomach, it is very 
apt to lead to an attack of diarrhoea. The use of 
decaying vegetable or animal matters is, as is well 
known doubtless to the reader, often the cause of 
bowel complaint. Exposure to extreme cold, or, still 
more frequently, great heat of the weather, will often 
induce diarrhoea. Anxiety and mental emotion may 
alone occasion this disorder of the intestinal canal. 
Diarrhoea, besides being a disease in itself, that is to 
say, the only disorder present, is frequently a symptom 
of other diseases, such as typhoid fever, the advanced 
stages of consumption, etc. 

The fatality of diarrhoea is, as a rule, not great. 
The very young and the very old, however, frequently 
die from it; so alro do those who are very much 
exhausted by illness. 

"When the disease runs into the chronic form, it 



986 DISEASES OF THE ORGANS OJ DIGESTION. 

is 'very difficult to get rid of. Many of the soldiers 
in our late war were months and years recovering 
from it. 

THE TREATMENT 

In mild cases consists simply in rest. The patient 
should merely lie down and keep quiet. The upright 
position and motion of every kind increase the 
frequency of the evacuations. But little food or 
drink should be taken. This treatment, with perhaps 
a dessertspoonful or tablespoonful of paregoric or a 
few drops of laudanum, will usually be all that is 
required in a mild attack. 

If the diarrhoea has been caused by the eating of 
indigestible or irritating food, it is well to begin the 
treatment by a dose of a purgative medicine, in order 
to secure as soon as possible the expulsion from the 
bowels of the offending material. A small tablespoon- 
ful of castor oil is an excellent and familiar remedy 
which operates mildly and freely. Instead of the oil, 
a dose of the cathartic we have recommended among 
the Standard Domestic Remedies may be taken. 

Should the looseness persist at all after resort to the 
above treatment, then astringents must be adminis- 
tered. Of these none is better than the astringent 
recommended on page 772. This should be given 
two or three times a day, in the dose directed, and at 
night a dose of the febrifuge (p. 777) taken. A hot 
foot-bath is useful in the evening, particularly if the 
skin be hot and dry. 

Attention must always be paid to the diet, which 



DIARRHCEA OR LOOSENESS. 987 

should be very plain and simple during and for some 
days after the attack. 

CHRONIC DIARRHCEA. 

Chronic or long-standing diarrhoea is much more 
difficult of treatment than the simple form of the 
affection. The diet in these cases, though light and 
easily digestible, must be nourishing. The coarser 
kinds of vegetables are to be avoided altogether. 
Exposure to cold and wet must be guarded against; 
but exercise in the open air, when the weather is 
favorable, is of benefit. In obstinate cases a change 
of climate or a long sea- voyage will frequently prove 
efficacious. 

The following prescription has a deserved reputa- 
tion in cases of chronic diarrhoea: — 



Take of— 

Subnitrate of bismuth, one ounce. 

Tannin, 

Dover's powder, of each, one drachm. Mix, 
Divide into twenty powders. 



One of these powders is to be taken three times a 
day. 

Directions for the prevention of diarrhoea will be 
found on page 272. 



988 diseases oe the organs of digestion. 

Dysentery, or Bloody Flux. 

This disease must not be confounded with diarrhoea. 
Both diarrhoea and dysentery are characterized by 
frequent passages, but here the resemblance, to a great 
extent, ceases. In dysentery there is usually more or 
less fever; the movements of the bowels are preceded 
by colicky pains, and accompanied by straining and 
bearing down; the passages are scanty and mixed with 
Mood; there is thirst, restlessness, and great loss of 
strength. These symptoms, particularly the pain and 
presence of blood in the stools, distinguish it from 
diarrhoea. It frequently happens, however, that dys- 
entery is ushered in by a simple diarrhoea of several 
days' duration. 

its fatal character when epidemic. 

This affection has in all times proved one of the 
most severe scourges of large armies and fleets, even 
in temperate regions. Not unfrequently the number 
of soldiers and sailors sick of it exceeds that of those 
sick from all other diseases combined. In all the 
European wars during the last two centuries it has 
followed in the track of the great armies. In 1748 it 
was active in the destruction of the British army in 
Holland. In 1792 it decimated the French, Prussian, 
and Austrian armies. The troops in the Crimea suffered 
severely from it in 1854. In the words of Sir Ranald 
Martin: "It is the disease of the famished garrisons 
of besieged towns, of barren encampments, and of 



DYSENTERY, OR BLOODY FLUX. 989 

fleets navigating tropical seas, where fruits and vege- 
tables cannot be procured. During the Peninsular 
war, the first Burmese war, and the late war with 
Eussia, dysentery was one of the most prevalent and 
fatal diseases which reduced the strength of the 
armies." During our own late war, about one-fourth 
of all the cases of disease reported during the first 
two years of the war were of dysentery. After camp 
fever, camp dysentery carried off more soldiers from 
both armies than any other disease. 

This affection, with its complications, is the great 
cause of death among the new-comers to tropical 
climates. 

THE CAUSES 

Of dysentery are quite numerous. In some cases it is 
epidemic, when its ravages in the community are very 
great. In unhealthy localities and in prisons it not 
unfrequently becomes epidemic, and then appears to be 
contagious in character. Indeed, by many physicians 
it is regarded as always contagious. 

Exposure to wet and cold will occasion it in those 
liable to an attack. Such exposure is particularly 
injurious in warm climates, in the chilliness of the 
evening after a hot day. Sleeping on the damp 
ground or between damp sheets will also give rise to it. 
Hence soldiers and travellers are much exposed to it. 
The malarial poison which produces chills and fevers 
also aids in the development of dysentery. Bad or in- 
sufficient food, excessive and continued fatigue, want 
of fresh vegetables and fruit, insufficient clothing and 



990 DISEASES OF THE ORGAN'S OF DIGESTION. 

bedding, and a confined, unwholesome air, all create a 
strong predisposition to an invasion of the disease. 
It is under these influences that those violent forms 
of dysentery arise which depopulate armies, fleets, and 
large cities. 

Dysentery is frequently associated with the various 
forms of bilious fever, constituting what is called 
bilious fever with flux. 

The camp dysentery which prevailed in our own 
armies during the war was largely caused by the 
scorbutic taint of many of the men, as was shown by 
the increased frequency of the complaint whenever 
the supplies of fresh vegetables and fruits were defi- 
cient. The influence of the season was very marked, 
the disease being more prevalent in the summer and 
autumn months. 

THE SYMPTOMS 

Of dysentery are, in brief, the following : — 

At the outset of the disease there is a feeling of 
discomfort and pain in the bowels of a griping 
character, with a frequent desire to go to stool. As 
the disease advances, the desire to empty the bowels 
becomes more frequent and the evacuations thin and 
bloody. These frequent passages afford the patient 
no relief, but, on the contrary, the straining efforts 
increase his discomfort. With these symptoms, there 
is more or less fever, great thirst, no appetite, furred 
tongue, and much prostration. 

In fatal cases of the disease, the belly becomes dis- 
tended and very sore to the touch; the patient is 



DYSENTERY, OR BLOODY FLUX, 991 

unable to sleep or to get more than a few short naps; 
the tongue is red and glazed; the discharges very 
loose and offensive; there is hiccough; a disagreeable, 
corpse-like odor from the body ; and great weakness 
and loss of flesh — death soon closing the scene. 

Directions for the prevention of dysentery will be 
found on page 272. 

THE TREATMENT 

Of dysentery should be instituted as early as possible 
in the affection. The patient should go at once to bed 
and remain there until well. - Even in the mildest 
cases, "keeping about" is a dangerous folly. The 
sick-room should be kept pure and well ventilated, 
and the diet must receive close attention. The food 
should be of a light and unstimulating character. 
Milk, cream, rice, and thin animal broths are to be 
taken freely by the patient, who must be supported by 
nourishment. Milk boiled with flour makes an excel- 
lent article of food, which should be given as often as 
possible during the day ; as it "is most grateful to the 
sufferer and beneficial when cold, it may be well iced. 
Small pieces of ice swallowed every now and then are 
pleasant and soothing to the stomach and relieve the 
nausea. Good beef-tea and extract of beef (see pp. 
490 and 492) are nutritious preparations which are 
very useful in this affection ; so also are raw eggs and 
ripe grapes. 

The warm bath may be employed with advantage. 
The application of large poultices over the bowels 
affords great relief. An injection of twenty-five or 



992 DISEASES OF THE ORGANS OF DIGESTION. 

thirty drops of laudanum in three or four tablespoons- 
ful of starch-water frequently relieves the pain. 

When the discharges are offensive, charcoal is of 
service ; it may be given in the dose of a teaspoonful 
morning and evening, in a little jelly. Blackberry 
tea is a useful domestic remedy ; for the dose and 
manner of preparing it, see p. 728. 

One of the remedies most frequently employed at 
the present time is ipecacuanha. The powder is the 
form selected, and the dose is a large one. The fol- 
lowing treatment is that employed in the practice of 
many physicians and hospitals : A large hot flaxseed 
poultice, containing a couple of tablespoonsful of 
mustard, is applied over the stomach ; an injection of 
thirty drops of laudanum in a small wineglassful of 
starch- water is carefully administered ; and then, in 
about three-quarters of an hour, thirty grains of the 
powder of ipecac are given, either as a large pill or 
mixed with some jelly or thick syrup. For three or 
four hours previous to the administration of the ipecac 
the patient must be forbidden to take any water or 
other fluids. A second dose of this medicine is not 
required. * When given in this large dose, it seldom 
produces any sickness at the stomach or vomiting, but 
quiets the excessive action of the bowels, acts kindly 
upon the liver, and induces a gentle and favorable 
moisture of the skin. 

In longstanding cases of dysentery it is often 
necessary to prescribe a change of climate. A hot 
salt-bath daily, or several times a week, just before 
going to bed, is highly recommended in chronic 



DYSENTERY, OR BLOODY ELUX. 993 

cases. The food should be nourishing, and whatever 
is found to disagree carefully avoided. The sleeping- 
room must be warm and dry, but well ventilated, and 
flannel worn next the skin at all seasons of the year. 
Some army surgeons give fifteen grains of powdered 
ipecac, on an empty stomach, twice a day, in the 
morning and evening, lessening the dose as the patient 
improves to ten and then to eight grains a day at bed- 
time. When the ipecac is stopped, the patient 
should take for a number of weeks after, to confirm, 
as it were, the cure, ten drops of the muriatic tincture 
of iron in a wineglassful of sweetened water (drawn 
into the mouth through a straw). 

Good nursing is of the utmost importance in dys- 
entery. Treatment by absolute rest to the body and 
bowels in bed, by scrupulous cleanliness of the person 
and clothes, by a pure warm atmosphere, and by a 
bland but nourishing diet, is of more consequence than 
by any medicine alone. 



63 



994 diseases of the organs of digestion. 

Liver Complaints. 

The liver is subject to a large number of disorders 
and diseases, some slight, some serious in their nature. 
Those who live in warm climates are particularly 
liable to affections of this organ. Many forms of 
liver complaints, such, for example, as enlargement, 
wasting, the presence of tumors, fatty or waxy degen- 
eration, and the like, are unrecognizable by the patient 
himself. Their serious character will lead him to 
seek medical advice. Even for the educated physician 
there is probably no class of diseases more difficult to 
recognize exactly than diseases of the liver. We 
cannot hope, therefore, to give our reader any informa- 
tion which will aid him in detecting or treating these 
obscure and difficult maladies. On one subject, how- 
ever, we believe we can give him some useful facts, 
namely, in regard to 

JAUNDICE. 

Jaundice may be defined as a yellowness of the 
skin and eyes, and indeed of all the tissues and secre- 
tions of the body. This yellowness is caused by their 
being impregnated with the coloring matter of the 
bile. The word jaundice is derived from the French 
word jaune^ which means yellow. The term for jaun- 
dice which is used by physicians {icterus) is derived 
from the Greek word for the golden thrush, a bird 
with golden plumage, the sight of which by a jaun- 
diced person was believed by the ancients to be death 



LIVER COMPLAINTS. 995 

to the bird, but recovery to the patient. Jaundice is 
also known under the name of the yellows. 



THE SYMPTOMS. 

"When the action or substance of the liver or bile-duct 
is disordered so as to cause the accumulation of the 
coloring matter of the bile (which is a fluid secreted 
by the liver) in the blood, the jaundiced tint pene- 
trates every part of the body that is permeated by the 
blood — even the brain and bones. The skin is espe- 
cially apt to be deeply tinged, but the yellowness is 
usually first observed in the whites of the eyes and 
roots of the nails. In slight cases the eyes alone are 
discolored. In severe cases the tongue becomes dis- 
distinctly yellow. 

The color of the skin varies from a pale sulphur or 
lemon color to a deep olive or bronzed hue. The tint 
varies with the cause and duration of the disease, and 
with the age, the natural complexion, and the amount 
of fat in the individual. It is lighter in young 
persons of fair complexion and with plenty of fat 
than in the old, the wrinkled, and dark-complexioned 
patient. 

A bitter taste in the mouth and much thirst are 
often complained of by the jaundiced. The digestion 
is usually disordered ; there is, in many cases, consti- 
pation and flatulence. The motions of the bowels 
present a pale drab or clay color. This is due to the 
absence of the coloring matter of the bile which is 



996 DISEASES OF THE ORGANS OF DIGESTION. 

naturally there, but which has now been absorbed into 
the blood and carried to all parts of the body. 

Itching of the skin, without any eruption, is a very 
troublesome and constant symptom. Sometimes ex- 
cessive eruptions appear on the skin, and the patient 
suffers from boils and carbuncles. When the jaundice 
has lasted a length of time, the blood becomes poor 
and watery, and the patient liable to attacks of bleed- 
ing from the bowels and stomach. The disordered 
condition of the digestive organs and of the blood 
necessarily soon produces general debility, low spirits, 
and irritability of the temper. 

It is a common notion that to the jaundiced eye all 
things appear yellow. This is not always, nor perhaps 
often, the case. In some instances, however, all white 
objects appear to the patient to be yellow. Occasion- 
ally, objects seem yellow when looked at with one eye, 
but not with the other. 



THE CAUSES OF JAUNDICE 

Are numerous. The passage of gall-stones is a 
frequent cause, particularly in middle and advanced 
life, and in those who lead sedentary lives. In some 
few instances, foreign bodies, such as cherry-stones, 
apple or currant seeds, have been known to find a 
lodgement in the bile-duct, closing up the opening by 
which the bile is discharged into the bowel, and thus 
giving rise to jaundice. In these instances, however, 
it is probable that the bile-duct has already been 
dilated by the passage of a gall-stone. Pregnancy, 



LIVEB COMPLAINTS. 997 

associated with constipation, sometimes gives rise to 
jaundice, which disappears after the birth of the child. 
"Violent and long-continued vomiting may lead to 
jaundice. Yery w r arm weather, long protracted, 
appears to have a decided influence in producing it. 
Thus, in the early fall a mild form of jaundice not 
unfrequently affects young persons, and particularly 
young girls, after an extremely hot summer. Various 
fevers give rise to jaundice, so also do some diseases 
of the nervous system. Dyspepsia and the abuse of 
alcohol are frequently the active causes. 



THE TREATMENT 

Of jaundice varies with the cause. In all cases, how- 
ever, the diet should be light and easy of digestion, 
fats, sugars, and malt liquors being forbidden. 

As the bow T els in most instances are constipated, 
laxatives will be necessary. An excellent pill is the 
following : — 



Take of— 

Rhubarb, six grains. 

Blue mass, two grains. 

Extract of henbane, two grains. Mix. 
Divide into three pills ; to be taken at night. 



Or, a tablespoonful of cream of tartar may be taken 
three times a day until the bowels are actively moved. 

Colic and various other dyspeptic symptoms may 
demand attention. The use of peppermint and cinna- 
mon will relieve the flatulence. So also will purified 
bile from the ox or pig, in closes of from three to six 



998 DISEASES OF THE ORGANS OF DIGESTION. 

grains, about two hours after meals. These dyspeptic 
symptoms are due to the absence of bile in the bowels 
— because of its retention in the liver and absorption 
into the blood — hence the usefulness of administering 
animal bile. 

The itching of the skin will be relieved by warm 
baths, by the use of the flesh-brush, and by taking 
twenty grains of bicarbonate of potash in water three 
times a day. 

When the patient is much debilitated, the tonic 
recommended among the Standard Domestic Remedies 
will be found of great service. 

The hot air-bath (page 468) is often beneficial ; so 
also are some of the natural mineral- waters (pages 646, 
647). 




CHAPTER X. 

DISEASES OF THE NERVES. 

CONTENTS. 

Neuralgia. Definition — Circumstances under which neuralgia appears — 
Influence of age, previous health, season of the year, climate — Is it danger- 
ous ? — The duration of neuralgia — The causes — The symptoms — Varieties 
of neuralgia — Neuralgia of the face — Brow-ague — Sciatica — Neuralgia of 
the side — The treatment : by diet, by medicines. 

Epilepsy. Definition of the disease — Circumstances under which it appears 
— Influence of age, sex, previous health, diet, inheritance — The causes — 
The duration — The symptoms — The treatment. 

Catalepsy. Nature of the affection — Its causes and remedies. 

Apoplexy. Causes, symptoms, and treatment. 

Palsy. The influences which induce it — The probabilities as to recovery — 
How to treat it. 

St. Vitus' Dance. Definition — Origin — Symptoms — Treatment. 



Neuralgia. 




HIS is a disease which consists of pain, and 
nothing else. In neuralgia there is ordinarily 
no inflammation, no swelling, no fever ; the trouble is 
in the nerves, and manifests itself only by pain of a 
darting, stabbing, boring, or burning character. This 
pain usually comes on suddenly, and, after lasting for 
a certain length of time, either passes entirely away 
or becomes much less severe. Succeeding an attack, 
the affected parts remain sore for a while and tender 
to the touch. 



( 999 ) 



1000 DISEASES OF THE NERVES. 



CIRCUMSTANCES UNDER WHICH IT APPEARS. 

The age has something to do with the liability to 
an attack of neuralgia. The disease is much more 
common after than before the fortieth year of life. 

The Previous Health, — At the time of the first attack 
of neuralgia, the condition of the patient is almost 
universally one of general debility. The individual 
is usually pale, the blood has been impoverished by 
some exhausting illness, fatigue, or sorrow. Even in 
those cases in which there is an externally healthy 
appearance, there is debility of the nervous system. 
This loss of general nervous strength precedes every 
invasion of neuralgia. 

Season of the Year. — Cold is one of the most promi- 
nent causes of an attack of neuralgia in those at all 
predisposed to the affection. Those seasons of the 
year in which there are cold winds are most dangerous 
to neuralgics. A very cold wind, mingled with sleet 
or driving rain, which keeps the skin sodden, is the 
worst influence to which such persons can be exposed. 

Climatic Influences. — Those districts which are sub- 
ject to ague or to damp and harsh cold winds are bad 
for persons with delicate nervous susceptibilities. 

IS IT DANGEROUS? 

A distinguished authority on nervous diseases has 
recorded as one of the characteristics of neuralgia the 
absence of danger to life. This statement is in a 
general sense a true one. But there are some cases 



NEURALGIA. 



1001 



of neuralgia of such severity as to break down the 
health and destroy the life of the sufferer. Some 
serious forms of neuralgia of the face occasionally 
lead to apoplexy and death. 

THE DURATION OF THE DISEASE. 

This varies with the character, cause, and location 
of the disease, the state of the general health, and the 
age of the patient. Most of the neuralgias of youth, 
which are comparatively rare and slight, either dis- 
appear altogether after a first attack, or gradually 
take their departure as the body consolidates. But 
neuralgia which first develops itself in old age is very 
likely, although apparently cured for a time, to return 
and continue to torment the patient for the rest of his 
life. The family history is also of importance in 
regard to the probable duration of the disease. Those 
whose families are liable to neuralgic affections rarely 
get rid altogether of a tendency to a return of the 
pain on a little exposure or indiscretion. 



THE CAUSES OF NEURALGIA. 

One of the most active causes is inheritance. The 
disease is transmissible from parent to child. It is a 
curious fact, also, that the children and grandchildren 
of those who have suffered from insanity, epilepsy, St. 
Vitus' dance, palsy, and the tendency to uncontrolla- 
ble excesses in the use of alcohol, are very liable to 
severe and obstinate forms of neuralgia. 



1002 



DISEASES OF THE NERVES. 



The children of consumptive parents are also pre- 
disposed to neuralgic attacks on the slightest provo- 
cation. 

Exposure to cold drafts of air is a common cause of 
an attack of neuralgia; so, also, is a sudden change 
of temperature. A wound or blow is sometimes 
followed by neuralgic pain which lasts long after the 
original injury has healed. Disorders of the stomach 
and decay of the teeth occasionally act as causes. 
The poisons of rheumatism and gout, of chills and 
fever, of lead and of large amounts of alcohol, are often 
to blame. "Whatever tends to break down the general 
health and exhaust the nervous forces, lays the patient 
open to the attack of neuralgia. 

In those predisposed to the affection, very slight 
occurrences, such as a sudden jar or shake, or mental 
emotion, are sufficient to bring it on. 

Persons who have attempted to commit suicide by 
taking arsenic, suffer excruciating pains along the 
course of the nerves of the limbs during convales- 
cence. 

THE SYMPTOMS. 



The manner in which the attack comes on is quite 
characteristic. There is always a degree of sudden- 
ness at the outset. "When produced by a violent 
shock, it may, and often does," says Dr. Anstie, 
"spring into full development and severity at once; 
of which, perhaps, the most striking example is the 
sudden and violent neuralgic pain of the eyebrow 



NEURALGIA. 



1003 



which some persons experience from swallowing a 
lump of undissolved ice. Usually, however, the first 
w r arning is a sudden, not very severe, and altogether 
transient, dart of pain. The patient has probably been 
suffering from some degree of general fatigue and 
malaise, and the skin of the affected part has been 
somewhat numb, when a sudden slight stitch of pain 
darts into the nerve. It ceases immediately, but in a 
few seconds or minutes returns ; arid these darts of 
pain recur more and more frequently till at last they 
blend themselves together in such a manner that the 
patient suffers continuous and violent pain for a 
minute or so, then experiences a short intermission, 
and then the pain returns again, and so on. These 
intermittent spasms of pain go on recurring for one 
or several hours; then the intermissions become 
longer, the pains slighter, and at last the attack wears 
itself out. Such is generally the history of first 
attacks, especially in subjects who are not past the 
middle age, nor particularly debilitated from any 
special cause." 

The pain is often the most severe that the human 
system ever is called upon to endure. It varies in 
character ; thus, some patients have compared it to a 
powerful electric shock, others to the conflagration of 
gunpowder. 

The periods of time between the attacks are uncer- 
tain. Sometimes they come on several times a day, 
at other times the patient will be free for weeks, 
months, or a year. 



1004 DISEASES OF THE NERVES. 

VARIETIES OF THE DISEASE. 

The principal forms of neuralgia are tic douloureux, 
or neuralgia of the face ; brow-ague, or neuralgia of 
the forehead ; sciatica, or neuralgia of the back of the 
thigh; and neuralgic pain in the side, between the 
ribs. We will consider first the nature of each of 
these affections before discussing their treatment. 

NEURALGIA OF THE FACE, OR TIC DOULOUREUX. 

The torture is usually confined to one side of the 
face. Sometimes the pain shoots over the cheek, 
lower eyelid, and upper lip ; sometimes it is confined 
to the lower lip, teeth, chin, and side of the tongue. 

As the presence of decayed teeth is alone sufficient 
to excite this form of the disease, the mouth in all 
cases should be carefully examined by a competent 
dentist. In one case on record a lady suffered severe 
pain in the ear and side of the neck for three months, 
and when she applied for advice had been deaf for 
many days. Upon the removal of a diseased molar 
tooth, the hearing returned in an hour. In another, 
happily quite extraordinary case, a young lady scarcely 
twenty years of age had suffered for more than a year 
from deep-seated pains in the face, teeth, and gums. 
The pain had gradually extended to all the teeth, and, 
one by one, all in the lower jaw excepting four had 
been removed. Every mode of treatment was re- 
sorted to without success. She finally became unable 
to take any solid food, the teeth of the upper jaw 



NEURALGIA. 



1005 






becoming so tender that the slightest touch caused 
acute pain. There was a constant flow of saliva from 
the mouth, while the sight of one eye was affected and 
the lids had been closed for two months, when the first 
molar tooth of the upper jaw on the side of the affected 
eye was extracted. Its removal gave great relief, and 
in two days the eye could be opened in a natural 
manner. But a perfect cure was only obtained by 
removing all the teeth. 

The most formidable forms of neuralgia of the face 
occur in advanced life. In severe cases there is 
spasm of the muscles, the attacks of pain being 
accompanied with hideous involuntary grimaces. The 
general appearance of a confirmed neuralgic of this 
class is very distressing. He is moody and low- 
spirited, he fears the slightest motion or the least draft 
of air. In consequence of the pain attending attempts 
at mastication, he is apt to be imperfectly nourished. 
In some unfortunate instances the patient seeks the 
stupefaction of intoxicating drinks, a most disastrous 
course, for it increases the disorder of the nervous 
system. 



BROW-AGUE, OR NEURALGIA OF THE FOREHEAD. 



This is an affection to which women are frequent 
victims. The pain is confined to one side of the brow 
and forehead. The one-sided character of the pain is 
not frequently detected in the earlier attacks, but as 
they increase in frequency and severity, this peculiarity 
is noticed. Brow-ague, or megrims as it is sometimes 



1006 DISEASES OE THE NERVES. 

called, is increased by dyspepsia, and is apt to be 
accompanied with nausea and vomiting when the pain 
is severe. In some instances vomiting relieves the 
pain, and the patient sinks into a comfortable sleep, 
awaking free from suffering. 

This disease almost always is associated with gene- 
ral debility. In its more severe forms it is a terrible 
affection. Occasionally the attacks come on only at 
certain hours of the day, a peculiarity which has given 
the malady the name of sun-pain, from the circum- 
stance that it sometimes appears with the rising and 
goes with the setting sun. 

SCIATICA. 

In this variety of neuralgia the pain is situated 
along the back of the thigh, following the course of a 
large nerve (the great sciatic). The pain frequently 
extends into the leg and foot. 

The young are comparatively exempt from this 
affection. Above the age of thirty, the number of 
male patients is much in excess of the female patients 
attacked. The causes are exposure to cold and mois- 
ture, rheumatism, over-fatigue, and excesses of various 
kinds. 

It is very rare that both limbs are affected. The dis- 
ease lasts from several weeks to a number of months. 

NEURALGIA OP THE SIDE. 

This form of neuralgia is very apt to be mistaken 
for pleurisy, the stitch in the side misleading the 



NEURALGIA. 1007 

patient, and occasionally the physician who neglects 
a careful examination of the chest. There is no 
variety of neuralgia more common than this. It 
not unfrequently accompanies consumption. All the 
vague pains which affect the chest- walls of the con- 
sumptive patient are not neuralgic, but it often 
happens that one of the earliest symptoms of this 
disease of the lungs is a well-marked attack of 
neuralgia of the side. The subjects are generally 
women of a sanguine temperament and quick intelli- 
gence. 

THE TREATMENT 

Of neuralgia consists chiefly in the improvement of 
the general health, and the removal of the special 
cause which is found to be at work. 

The disease is, as we have before mentioned, almost 
always preceded and accompanied by debility, hence 
the importance of a tonic and restorative treatment. 
The patient should take exercise in the open air; be 
warmly clad with flannel next the skin ; have a nour- 
ishing diet, with plenty of fat ; avoid tea, but take 
plenty of milk; and shun exposure to cold and damp- 
ness. Chamois-leather drawers are useful and com- 
fortable in sciatica. 

Neuralgics are particularly apt to neglect all kinds 
of fat, partly because they dislike it, and partly 
because they fear it will make them bilious. The 
following remarks on this subject from the pen of an 
English physician, Dr. Anstie, of very large experi- 



1008 DISEASES OE THE NERVES. 

ence with this disease, we commend to the close 
attention of all our neuralgic readers. "By the time 
patients have become sufficiently ill with neuralgia to 
apply to a consulting physician, they have already, in 
the great majority of cases, got to reject all fatty 
foods, and have cut down their total nutriment to a 
very insufficient standard. Young ladies suffering 
from migraine are especially apt to mismanage them- 
selves to a lamentable extent in this direction. This 
is natural enough, because the stomach disorder seems 
to them the origin of the pain, instead of being, as it 
is, merely a secondary consequence. But it is not 
only the sufferers from sick headache in whom we find 
this tendency to insufficient eating, especially of fat; 
not to mention that all severe pain usually tends to 
disorder the appetite and make it fastidious, there is 
nearly always some wiseacre of a friend at hand, 
ready to suggest that neuralgia is something very 
like gout, that gout is always aggravated by good 
living, and therefore that the patient should be 
4 extremely cautious as to diet;' the end of which is 
that the poor wretch becomes a half-starved valetudi- 
narian; but, so far from his pain getting better, it 
steadily becomes worse. I cannot too strongly express 
the benefits that I have seen accrue, in the most 
various kinds of neuralgic cases, from persistent efforts 
to remedy this state of things, and to convert the 
patient from a valetudinarian to a hearty eater; and I 
wish particularly to say that this success has always 
been most marked when I have from the first insisted 
on fat forming a considerable element of the food. 



NEURALGIA. 1009 

Cod-liver oil is the preferable form in which to give 
it. But the very cases in which we most urgently 
desire to give fats are often those in which the 
patient's fantastic stomach openly revolts at the idea 
of the oil. "We must then try other fats, and should 
go on trying one thing after another — butter, cream, 
even olive or cocoa-nut oil — till we get the patient 
well into the way of taking a considerable, if possible 
a decidedly large, daily allowance of fat, without 
provoking dyspepsia. It is surprising what can be 
done in this way by perseverance and tact, and it is 
no less striking to observe the good effects of the 
treatment." 

!Not only should the amount of fat taken be 
increased, but the total amount of food. Let those 
patients who are prejudiced against such a method of 
treatment try it. The quantity of food should be 
increased about one-third more than the patient would 
have probably eaten in health. Particularly in the 
very young and the aged who are sufferers, is this 
generous diet important — and in all cases it consti- 
tutes a sound basis for other treatment. 

Of all medicines, iron is the most beneficial in the 
majority of cases. "We, therefore, strongly recom- 
mend the tonic of the Standard Domestic Remedies. 

The carbonate of iron is a useful preparation, given 
in doses of fifteen or twenty grains, two or three 
times a day, in molasses. This method of treatment, 
if persevered in for several months, will almost always 
relieve and frequently cure this justly dreaded dis- 
ease. "While using it, the bowels must be kept clear 

64 



1010 DISEASES OF THE KERYES. 

by securing a daily passage by small doses of laxative 
medicines if necessary, such as a Seidlitz powder in 
the morning, a small quantity of cream of tartar or 
citrate of magnesia, or of the purgative of the Standard 
Domestic Remedy series. 

In some instances electricity or galvanism is of 
much service. 

Sal-ammoniac is often very beneficial. Twenty 
grains of it should be given at a dose, mixed in a half 
tumbler or more of water, while the attack of pain is 
on. This dose should be repeated every hour; but if 
after the fourth there is no diminution of the pain, it 
is useless to persevere. "When the pain is relieved by 
it, as is often the case, the medicine should be con- 
tinued in fifteen-grain doses three times a day for a 
week after the attack. 

A liniment made of a mixture of equal parts of 
tincture of aconite and soap liniment, rubbed over the 
painful part, is useful. Or, the pure tincture of aco- 
nite may be rubbed on with a rag until a prickling 
sensation is produced. 

Tea generally aggravates neuralgia, and snould 
therefore be avoided by those suffering from it ; coffee, 
on the contrary, is often of service, particularly if 
made strong. A cup of strong coffee in which the 
juice of a lemon has been squeezed affords relief, 
especially in neuralgic headache. 

In neuralgic pain of the face, the application of a 
hot salt-bag to the back of the neck at night, with 
the use of arsenic during the day, is of advantage 



NEURALGIA. 1011 

in many cases. The following prescription may be 
given : — 



Take of— 

Fowler's solution of arsenic, one fluidrachm. 
Aromatic syrup of rhubarb, three fluidounces. 
Mix. 

Take a teaspoonful three times a day, after meals. 



A mixture of hemlock and sal-ammoniac is fre- 
quently prescribed with success for neuralgic head- 
ache : — 



Take of— 

Fluid extract of hemlock, one fluidrachm. 

Sal-ammoniac three drachms. 

Syrup of orange-peel, 

Water, of each, two fluidounces. Mix. 
A teaspoonful three times a day 



1012 diseases op the nerves. 

Epilepsy. 

Epilepsy is a disease of the nervous system charac- 
terized by convulsions or fits. The fits are attended 
with unconsciousness. They come on at uncertain in- 
tervals, and last ordinarily from five to twenty minutes. 
Sometimes they make their appearance suddenly, 
surprising the patient without warning, but usually 
they are ushered in by a peculiar feeling. This feeling 
is often described as the sensation of a current of cold 
air or vapor, which, rising in some part of the body, 
proceeds towards the head, and as soon as it reaches 
the brain the patient falls. After the fit, the patient has 
no recollection of what occurred during it, but remains 
dull and weak for some time after. We shall shortly 
describe more closely an epileptic seizure or fit. 

THE CIRCUMSTANCES UNDER WHICH EPILEPSY 
APPEARS. 

Age. — The period of life between ten and twenty 
years of age is the one in which the greatest number 
of epileptic patients are first affected, and of these by 
far the larger number show their earliest symptoms 
between the ages of thirteen and seventeen inclusive. 
Between twenty-five and thirty-five there are com- 
paratively few first attacks. But after fifty years of 
age the tendency to the disease increases. 

Sex. — Under the age of seven there is no difference 
between the sexes in regard to their liability to 
epilepsy. But after puberty it is more common 



EPILEPSY. 1013 

among males than females. There is a curious excep- 
tion to this rule; all authorities agree that in France, 
or at least in Paris, there are more women affected 
with epilepsy than men. Esquirol, one of the best 
French authorities on the subject, alleges that the 
number of women attacked is one-third greater than 
that of men. English physicians are unanimous in 
their statements as to the greater prevalence of the 
disease among men. The Registrar-General of Eng- 
land says: "The mortality of males at all ages from 
epilepsy is 52.26 per cent., of females 47.73 per cent., 
and that, therefore, 4.53 per cent, of male deaths occur 
from epilepsy in excess of female deaths from that 
cause; or, to put it in a different way, we find that 
the average male deaths in one year from epilepsy 
are 961.3, of females 878.1 ; so that annually, in Eng- 
land and "Wales, 83.2 more males die epileptic than 
females." From the United States Census we learn 
that in America more men die epileptic than women. 

Not only is the disease more common among men 
than women, but the former when attacked are more 
apt to die of the affection than the latter. 

Previous Health. — "When there is a powerful ten- 
dency to epilepsy, it often appears while the patient is 
in the best of health. Severe diseases, such as fevers 
and smallpox, and injuries about the head, or shocks 
to the nervous system, predispose to the disease. So, 
also, in some instances, do rheumatic affections. 

Diet — Errors in diet are common exciting causes 
of an attack, in those at all inclined to the disease. 
European army surgeons report as a frequent cause 



1014 DISEASES OF THE SERVES. 

of a fit among soldiers, gorging the stomach with 
beer. 

Inheritance. — A tendency to epilepsy is, without 
question, frequently hereditary. It may appear in 
both parent and child, or, skipping over a generation, 
pass to the grandchild. 

THE CAUSES OF EPILEPSY. 

We have just mentioned the influence of inheri- 
tance as a cause. Dissipation and all forms of excess 
are prominent among the agencies which lead to this 
terrible disease. Malformations of the head, in- 
sanity, and injuries of the brain, are often to blame for 
the invasion. Mental emotion and fright are common 
causes. Thus, very appropriately, Raphael, in his great 
picture of the Transfiguration, represents a boy falling 
into an epileptic fit. The irritation of teething in 
children so frequently induces fits, that in France one 
of the terms by which epilepsy is designated is u mal 
des enfans" — the diseases of children. "Worms and 
the poison of rheumatism occasionally have something 
to do with the development of epilepsy. 

THE DURATION OF THE DISEASE. 

The average duration of a fit is from five to twenty 
minutes. Sometimes, however, it lasts for an hour or 
more. In children it rarely exceeds a few minutes' 
duration. The intervals between the fits are variable. 
At first three or four months may elapse, but soon 



EPILEPSY. 1015 

they come more frequently, until finally scarcely a day 
passes without one or more fits. 

The epileptic convulsions which attack some chil- 
dren during the period of teething, disappear as a rule 
about the second or third year. When the disease 
first makes its appearance about the third or fourth 
year, it generally is cured before the age of puberty is 
attained — provided it be not the result of inheritance. 
Epileptics seized after the age of puberty are difficult 
of cure. Before the discovery of the bromide of potas- 
sium very few cases ever recovered. The wonderful 
effects of this remedy mark a new era in the history 
of this disease. "When epilepsy is conjoined with 
insanity, the case is nearly hopeless. 

The probability of cure in any given case is the 
greater the less the number of fits that have occurred 
before the treatment. One fit scarcely ever leaves 
behind it a permanent ill effect. The case after the 
first fit is, therefore, a very hopeful one. "When the 
number of fits is very great, a sort of habit is formed 
which it is very difficult to eradicate. 

THE SYMPTOMS 

Of epilepsy may be divided into those which precede 
a fit and those which constitute the fit. 

One of the earliest symptoms, which sometimes long 
precedes an attack, or may indeed not be followed by 
the disease at all, but pass off without apparent evil 
result, is that peculiar feeling so well described by 
Charles Dickens as " a feeling which comes over us 



1016 DISEASES OF THE NERVES. 

occasionally, of what we are saying and doing having 
been said or done before, in a remote time — of our 
having been surrounded, dim ages ago, by the same 
faces, objects, and circumstances — of our knowing 
perfectly what will be said next, as if we suddenly 
remembered it." 

This feeling is not the innocent one that it was 
evidently thought to be by Mr. Dickens. It indicates 
a disturbance of the action of the brain, and, particu- 
larly when it comes on after over-mental work, should 
not be lightly regarded. The poets frequently allude 
to this feeling. Thus Coleridge : — 

" Oft o'er my brain does that strange fancy roll, 
Which makes the present (while the flush doth last) 
Seem a mere semblance of some unknown past, 
Mixed with such feelings as perplex the soul 
Self-questioned in her sleep ; and some have said 
We lived, ere yet this robe of flesh we wore." 

And, again, Tennyson: — 

"Moreover, something is or seems 
That touches me with mystic gleams 
Like glimpses of forgotten dreams — 

Of something felt, like something here ; 
Of something done, I know not where ; 
Such as no language may declare. ' ' 

We repeat, that this feeling, if at all frequent or 
intense, should be regarded as a warning, and lead to 
a reform in whatever is undermining the healthful 
action of the brain. 

Many epileptics have warnings peculiar to them- 
selves of the approach of a fit. Thus one, when a fit 



EPILEPSY. 1017 

was approaching, always saw a little old woman in a 
red cloak advance towards him, and strike him a blow 
on the head, on receiving which he became unconscious 
and fell. Others suffer in advance of a fit from head- 
ache, dizziness, dimness of vision, sickness at the 
stomach, or a feeling of terror. The most common 
premonitory sensation is that known as the epileptic 
aura. This differs in different persons. In some the 
patient has the sensation of a stream of cold water 
flowing from the fingers or toes upwards towards the 
body; others feel as if a spider or insect was creeping 
over the skin ; others as if a current of cold or warm 
air was passing over the surface of the body, from the 
extremity of one limb up towards the head; as soon 
as the moving sensation stops, then the fit comes on. 
In some patients the fits are ushered in by noises in 
the ears, such as the ringing of bells or the roaring of 
the sea; in others the sense of smell is affected, and 
they are troubled by disagreeable odors; while others, 
again, are annoyed by unpleasant tastes in the mouth. 

DESCRIPTION OP AN" EPILEPTIC FIT. 

Dr. Aitken, in his works, gives such a graphic 
description of an epileptic fit, that we reproduce it 
here, with such verbal alterations as are needed to 
make it intelligible to the non-medical reader. 

In the adult, whether the warning symptoms (which 
we have mentioned above) be or be not present, the 
attack usually commences by the patient uttering a 
cry, losing on the instant all knowledge of what is 



1018 DISEASES OF THE NERVES. 

going on about him, and, falling down in a fit, his 
mouth all covered with foam. The fits vary from the 
most trifling movements to the most frightful, terrific, 
and long-continued struggles. In mild cases, only 
one limb is convulsed; in others, only the face, the 
lips, or the eye. A case is related of a lady whose 
fits were so slight that, although often seized on 
horseback, she never fell off. In a few seconds she 
recovered, and resumed the conversation by finishing 
the sentence she was expressing. The epileptic cry, 
and the convulsed eye, denoted the true nature of the 
attack. Attacks so mild may occur many times in 
the day, and appear for a time to leave no feeling of 
ill-health behind. 

In severe forms of epilepsy the fit is more formida- 
ble ; the hair stands on end, the forehead is wrinkled, 
and the brow is knit. If the eyelids be opened, the 
eye is seen to be red, sometimes convulsively agitated, 
at other times squinting, and sometimes fixed; more 
commonly the eyelid is quivering, and half-open, so 
as to show the lower portion of the white of the eye. 
The face is red, or livid and swollen, the teeth gene- 
rally clenched, and the lips covered with foam; some- 
times, however, the mouth is open and the tongue 
thrust forward, and occasionally in this position it is 
bitten through, or much injured, and the foam about the 
mouth consequently mixed with blood. The force 
with which the jaw closes is sometimes so great that 
teeth have been known to be broken and the jaw 
dislocated. The limbs, also, are violently convulsed, 
thrown about in every direction, and with such power 



EPILEPSY. 1019 

that it often requires three or four persons to prevent 
the patient seriously hurting himself. The hands are 
strongly clenched, and the body is often arched back- 
ward; when, on the muscles relaxing, the patient may 
fall to the ground with great force. The pulse is 
generally frequent, sometimes scarcely perceptible, 
although the heart-beats are strong and tumultuous. 
The breathing is noisy, and the skin bathed in sweat. 
Blood sometimes flows from the eyes, ears, or nose, 
frightfully expressive of the violence of the attack. 

When the fit has reached its crisis, the muscles 
relax, the movements subside, the breathing becomes 
more free, the pulse more regular, and the countenance 
more natural; and at length the patient falls into a 
heavy sleep, from which he awakes sometimes in good 
health, but more often shaken, exhausted, and suffering 
from severe headache, which lasts some hours or even 
days. In neither case, however, has he the slightest 
remembrance of what has passed. In other instances, 
the termination of one fit is but the beginning of 
another, and the succession is occasionally so con- 
tinued that the attack, with short intermissions, may 
last twenty-four or forty-eight hours, or even longer. 

"When children, from teething or other causes, are 
seized with an epileptic fit, the attack is generally 
preceded by a hooping or crowing sound. When the 
fit begins, the thumb is drawn in, the fingers clenched, 
and the toes bent ; the eyes are staring, fixed, or con- 
vulsed; the face and limbs pale or livid; the body 
rigid, and curved backward. These symptoms gene- 
rally last only a few minutes, when a strong breathing 



1020 DISEASES OE THE NERVES. 

out of the air in the chest takes place ; a fit of crying 
succeeds, and the child, much exhausted, recovers, 
and, after a while, falls asleep. 

THE TREATMENT 

Is now, as we have previously remarked, a much more 
hopeful one than formerly. The bromide of potassium 
is the best friend the epileptic has. This medicine 
should be taken, in doses of twenty grains, three times 
a day. It should be persevered in for a long time. 
The patient is not safe a single day without it, until 
he has been entirely free from an attack for at least 
fifteen or sixteen months. 

A gentle purgative, taken every month, increases 
the usefulness of the bromide of potassium. 

Often good results are obtained from combining the 
bromide of potassium with the bromide of ammonium, 
ten grains of each, three times a day. Or, the follow- 
ing prescription may be taken, which is that recom- 
mended by Dr. Brown-Sequard, the highest medical 
authority on this disease now living: — 



Take of— 

Iodide of potassium, 

Bromide of potassium, of each, one drachm. 

Bromide of ammonium, half a drachm. 

Bicarbonate of potash, two scruples. 

Infusion of columbo, six fluidounces. Mix. 
A teaspoonful before each of the three meals, and two 
tablespoonsful at bedtime, in water. 



The diet of the epileptic patient should be light. 
The patient must live temperately. As the tendency 



EPILEPSY. 1021 

of epileptics is to overload the stomach, this must be 
carefully guarded agaiust. Daily exercise in the open 
air must be insisted upon. The head should be kept 
cool, and the feet warm. The epileptic should be an 
early riser. 

The treatment of epilepsy occurring in children 
consists in the use of the warm bath and the admin- 
istration of bromide of potassium, but in smaller doses 
than to the adult, in accordance with the rule given on 
page 549. 

The treatment during a fit consists in placing the 
patient on a large bed, and in a room with plenty of 
fresh air; loosening his clothing, especially about the 
neck ; introducing a piece of soft wood between the 
teeth, to prevent his biting the tongue ; and, if the face 
be very red, apply cold water to the head. The appli- 
cation of mustard plasters to the wrists and ankles is 
a harmless procedure, though probably not attended 
with much benefit. There is no medicine which can 
be administered with advantage during the fit : the 
principal treatment of a fit lies in preventing the pa- 
tient from injuring himself by his violent movements. 



1022 DISEASES OF THE NERVES, 



Catalepsy. 



The word catalepsy is derived from the Greek, and 
means to restrain or hold firmly. It is applied to a 
disease of the nervous system which consists in a 
sudden loss of consciousness and of the power of 
motion — the patient remaining in the same position 
he had at the moment of seizure : if sitting, continuing 
to sit ; if standing, continuing to stand ; the counte- 
nance retaining the same expression it had just before 
the attack. 

The attack may last only a few moments, or for 
several hours, and even days. The patient recovers 
suddenly, as if awaking from a deep sleep, and has no 
recollection of what has occurred. 

This disease is much more common with the female 
than the male sex. Nervous, hysterical women are 
its most frequent victims. It is not dangerous. In 
some very rare cases it terminates in insanity or 
softening of the brain. More frequently it is the 
forerunner of epilepsy. 

The " absence of mind" from which many persons 
suffer is a light and modified form of catalepsy. As 
Dr. Laycock, in his Treatise on the Nervous Diseases 
of "Women, remarks : " In brown-study or reverie the 
eye is fixed by a muscular action analogous to the 
cataleptic ; and not the eye only, for a limb or the 
whole body will remain in the same position for many 
minutes ; the senses themselves being in deep abstrac- 
tion from surrounding objects." Dr. Tanner states 
that " in some individuals a cataleptic state may be 



CATALEPSY. 1023 

induced by strongly fixing the attention on one object 
for a short time. The mental faculties get tired; there 
is diminished nervous influence or force ; and persons 
so affected then believe that they are unable to move, 
cannot see, etc., until the so-called mesmerizer grants 
them permission. Examples of this state are also 
seen in animals — as in birds and rabbits fascinated by 
the glaring eyes of the serpent." 

The following case is related upon excellent medical 
authority. "We give it as affording the reader a better 
picture of the disease than any mere description of 
the symptoms could do. 

A lady, who labored under melancholy, was seized 
with catalepsy, and presented the following appear- 
ances : She was lying in bed motionless, and appa- 
rently senseless. Her eyes w^ere open, but there was 
no rising of the chest, no movement of the nostril, no 
appearance of breathing. The only signs of life were 
warmth and a pulse which was 120 and weak. In 
attempting to arouse her from this senseless state, the 
trunk of the body was lifted up and placed so far 
back as to form an obtuse angle with the lower ex- 
tremities, and in this posture, with nothing to support 
her, she continued sitting for many minutes. One arm 
was raised by a bystander, and then the other, and in 
the posture they were placed they remained. It was 
a curious sight to see her sitting up, staring lifelessly, 
her arms outstretched, yet without any visible signs 
of animation. She was very thin and pallid, and 
looked like a corpse which had been propped up and 
stiffened in that attitude. She was now taken out of 



1024 DISEASES OF THE NERVES. 

bed and placed upright, and attempts were made to 
rouse her by calling loudly in her ears, but in vain ; 
she stood up indeed, but as inanimate as a statue. 
The slightest push put her off her balance, and she 
made no exertion to regain it, and would have fallen, 
had she not been caught. She went into this state 
three times ; the first attack lasted fourteen hours, the 
second twelve hours, and the third nine hours, with 
waking intervals of three days after the first fit, and 
of one day after the second. 



THE TREATMENT 

Of catalepsy consists in the improvement of the gene- 
ral health, and the toning up of the nervous system 
by generous diet, recreation, travel, and tonic reme- 
dies. Patients of this character should never be sub- 
jected to the charlatanism of mesmerizers. On the 
contrary, those about them, and who have charge -of 
them, should, by what power of command they have, 
seek to demesmerize them, and to supply their defi- 
ciency of will. The mental and moral influences to 
which the cataleptic is subjected should be healthy ; 
he or she should be encouraged to combat energeti- 
cally all tendencies to reverie and absence of mind. 
Constant, pleasant, mental* and physical employment 
is of the greatest advantage. 

The condition called ecstasy is similar to catalepsy. 
The eyes are immovably fixed, and the patient, insen- 
sible to what is going on around him, is closely occu- 
pied in the contemplation of some imaginary object. 



CATALEPSY. 1025 

The famous convulsionaries of St. Medard were thus 
affected, and many of the impostors of the present day- 
are not wilful deceivers, but simply nervous persons, 
mostly women, suffering from this or some similar' 
disease of the nervous system. 



1026 diseases of the nerves. 

Apoplexy. 

By an apoplectic stroke, or apoplexy, is meant a 
sudden loss of consciousness, feeling, and power of 
motion. The term is derived from two Greek words 
which mean to strike by means of — because those 
attacked fall down as if by means of a blow. 

the causes 

Of epilepsy are many of them avoidable. "Whatever 
tends to cause a rush of blood to the head may occa- 
sion an attack. For this reason, the immoderate use 
of intoxicating liquors, tobacco, and opium is some- 
times to blame. Violent mental excitement, great 
heat or cold, blows upon the head, and various diseases 
of the heart and brain, particularly those associated 
with advanced life, are common causes of an attack. 

THE SYMPTOMS 

Are those which precede an attack, which may be 
properly called the warnings, and those which are 
present during the attack. 

Although the apoplexy sometimes appears suddenly 
in persons who, up to the moment of seizure, feel quite 
well, yet it is ordinarily ushered in by certain symp- 
toms which give warning of the coming attack. 
Headache, heaviness and fulness of the head, noise in 
the ears, flashes before the eyes, sleeplessness, and 
irritability of the temper, are often complained of for 



APOPLEXY. 1027 

days in advance. Momentary loss of memory of words 
or ideas frequently precedes an attack, so also does a 
peculiar feeling of creeping or numbness of the limbs. 
Drowsiness and indistinctness of utterance, and partial 
palsy of one limb or of some of the muscles of the face, 
or of the eyelids, are very threatening symptoms of an 
apoplectic stroke. 

Apoplectic strokes occur at all seasons of the year 
and at all hours of the day. Extensive statistical 
tables have been made in reference to their compara- 
tive frequency in the morning, mid-day, and evening. 
Advanced age furnishes by far the greater number of 
cases, but it is not unknown among children. 

Men are oftener attacked than women. As we 
pointed out in our work upon the Hygiene and 
Diseases Peculiar to Men,* this may be accounted for, 
in part, by the w T ell-known fact that one of the most 
active causes of apoplexy is the intemperate use of 
fermented liquors, which, in some constitutions, pro- 
duce a speedy impairment of the functions of the 
brain. Alcohol also exerts a pernicious influence, in 
many instances, upon the heart and arteries. The 
heart's action is not only increased under its influence, 
but positive alterations in the structure of the blood- 
vessels take place. In such instances we find the 
movements of the heart permanently quickened, and 
the blood, therefore, driven more forcibly to the brain, 
while the coats of the arteries, having lost their elas- 
ticity by a thickening or thinning of their substance, 

* "The Transmission of Life," p. 290. 



1028 DISEASES OF THE NERVES. 

are more readily ruptured by this forcible current, 
and hence the tendency to hemorrhage in the brain is 
vastly increased. The excessive use of tobacco is also 
supposed to predispose to congestion of the brain, and 
consequently to apoplectic attacks. As the excessive 
employment of tobacco and alcohol is essentially a 
vice of the male sex, we may attribute to these arti- 
cles, in part, the greater liability to apoplectic attacks 
to which men are the victims. 

The duration of a fit varies from a few hours to 
several days. 

During the fit, the patient is entirely insensible, the 
breathing is slow and often noisy, the face is pale, the 
eyes dull and glassy and the pupils large, the skin is 
cold and clammy, and the power of swallowing is 
impaired or lost. The bowels are torpid, or act invol- 
untarily. When the patient recovers from the fit, 
more or less palsy of one or more limbs is apt to 
remain. 

The disease is of course a dangerous one, and the 
danger increases with each attack that the patient has. 
There is a common belief that a patient always 
recovers from a first attack completely, that after the 
second he has palsy, and that he dies of the third. 
This, although not strictly true, expresses properly 
the increasing danger with each succeeding fit. 



APOPLEXY. 



1029 



THE TREATMENT 



Is naturally divided into that instituted to prevent an 
attack, and that proper when an attack has actually 
occurred. 

Dr. Tanner, in his work on the Practice of Medicine, 
enumerates a number of useful precautions to be 
observed by the individual who has a predisposition to 
apoplexy. He should avoid strong* bodily exertion, 
all the excitements of passion, any stimulation ap- 
proaching to drunkenness, violent mental emotion, 
exposure to extremes of temperature, straining at 
stool, long-continued stooping, tight neckcloths, and 
warm baths. He ought to observe a moderately spare 
diet, free from alcoholic drinks; heavy meals being bad 
and dangerous. He should sleep with his head high, 
on a mattress rather than on a featherbed, in a cool, 
well-ventilated room, and for not more than eight 
hours. He ought to take daily exercise in the open 
air; and must pay great attention to his bowels. 
Washing the head in the morning with cold water is 
often useful. When giddiness, headache, throbbing 
in the head, and bleeding from the nose are present, 
much benefit will result from a dose of a purgative, as 
well as from blistering the nape of the neck. On the 
contrary, when the patient is pale and weak, small 
doses of iron, good, easily digested food, and plenty of 
milk will be needed. 

We also refer the reader to our remarks on the pre- 
vention of apoplexy and palsy on page 267. 

During an attack the patient should rarely or never 



1030 DISEASES OF THE JSTERVES. 

be bled. The former injudicious custom of bleeding 
in every stroke of apoplexy was productive of much 
harm. The feet should be placed in a hot mustard 
foot-bath, and mustard plasters should be applied to 
the wrists. The patient should be placed in a cool, 
well-ventilated room ; his clothes, particularly those 
about the neck, loosened; his head raised; and cold 
applied to the head by means of pounded ice in a 
bladder or bag. 

For a long time after recovery from an attack the 
patient should take great care of himself, and avoid 
all undue exertions of the mind or body. The diet, 
though nourishing, should be light and unstimulating. 
A pint or two of milk taken daily is of great service. 

Palsy, 

Palsy, or paralysis, is a loss of motion or sensibility, 
or both, in one or more parts of the body. 

It may be due to an apoplectic stroke, to epilepsy, 
to St. Vitus' dance, to softening of the brain, to disease 
of the spine, or to the influence of certain poisons in 
the system. Whatever the cause, the affection is 
always a serious one. It demands and should receive 
the care of a competent physician to detect the cause 
and apply the remedy. 

A case of palsy must not be necessarily regarded as 
a hopeless one. In many cases the cause is a com- 
paratively slight one — such as poisoning by lead, for 
example — which can readily be removed, and recovery 
will soon follow. Even when the brain itself is 



PALSY. 1031 

affected, a perfect cure can often be had at the hands 
of a skilful physician or surgeon. 

In accordance with the rule we have laid down for 
ourselves in this work, of treating but slightly or not 
at all of those diseases which cannot be recognized 
and treated by non-medical persons, we shall abstain 
here from enumerating symptoms and methods of 
treatment in this disease. A knowledge of them 
would be of no practical benefit to any one. Here the 
advice of the intelligent physician is imperative. It 
should be had as early as possible, in order that the 
progress of the disease may be checked, if possible, 
before irreparable mischief is done. 



1032 diseases of the nerves. 

St. Vitus' Dance. 

This disease, which has been appropriately termed 
an "insanity of the muscles," consists in irregular 
and twitching motions of the muscles of the limbs and 
face, which motions are entirely without the control 
of the patient. He tries, but is unable to restrain the 
mortifying movements of the affected parts. 

The causes of the disease are quite numerous. 
Whatever profoundly impresses the nervous sy$tem 
may produce an attack. Hence, a fright, or a blow 
or fall, by the shock it occasions, may develop the 
disease. Worms in the bowels are sometimes the 
cause. It occurs very frequently after an attack of 
rheumatism in children, hence the poison of rheuma- 
tism has been supposed to exert an influence in its 
causation. 

The disease is most common in girls between the 
ages of six and fifteen, but boys of the same age 
sometimes suffer from it. 

Although the affection is not contagious, it is con- 
tracted not unfrequently by nervous children from 
observing the movements of those affected by it. We 
may here apply, in a wider sense than they were, the 
words of Falstaff: "It is certain that either wise 
bearing, or ignorant courage, is caught, as men take 
diseases, one of another ; therefore, let men take heed 
of their company." 

The treatment of St. Vitus' dance lies mainly in the 
improvement of the general health rather than in any 
special medication. The tonic recommended in the 



ST. VITUS' DANCE. 1033 

Standard Domestic Remedies should be given, a 
generous diet insisted on, and a change of scene 
secured if possible. A child will be more benefited 
by a sojourn at the seaside than by any medicine 
which can be given it. The cold shower-bath is a 
most valuable remedy, and should be employed early 
every morning. The patient ought to have plenty of 
milk, and exercise in the open air. A system of light 
gymnastics, such as we have recommended on a pre- 
vious page, will be found of great service. Excitement 
of every kind must be guarded against. 




CHAPTEE XL 

ON FEVERS. 

CONTENTS. 

Chills and Fever. Peculiarities of this affection — Its different varieties — 
The cause — The treatment. 

Typhoid Fever. The nature of the fever — The various names it bears — 
The causes — Is it contagious? — The symptoms — The treatment — Impor- 
tance of good nursing — How to nurse a case of typhoid fever. 

Typhus Fever. Definition of the disease — The circumstances under which 
it appears — Is it contagious? — The symptoms — The duration — The treat- 
ment. 

Yellow Fever. Its character — The causes — Is it contagious ? — The symp- 
toms — The treatment. 




Chills and Fever. 

HIS disease is aptly named. It begins with a 
chill, and ends with a fever and perspiration. 
It consists, therefore, of three distinct stages — the 
cold, the hot, and the sweating. 

There is another peculiarity about this disease. It 
is intermittent — that is, there are a series of attacks, 
with pauses or intervals between, during which the 
patient is free. There is also a regularity in regard 
to the reappearance of the attacks. The patient has 
his chill, with business-like promptness, every day, 
(1034) 



chills a:nt> fevers. 1035 

every other day, or on every third day. It is emi- 
nently a periodical affection. 

There is only one cause for this disease, namely, 
malaria or miasm, that is, bad air — air impregnated 
with exhalations from the earth, in marshy districts, 
or where decaying vegetable matters are exposed to 
the sun. 

In the first part of this book, we entered, at some 
length, into the prevention of this disease, noted the 
temporary precautions which should be observed by 
those exposed to the poison of malaria, and enume- 
rated the specific and permanent preventives. We 
need, therefore, in this connection, only refer our 
reader back to page 250. 

THE TREATMENT 

Of chills and fever is a specific one. It is one of the 
few diseases for which we know a specific. This spe- 
cific is Peruvian bark, or one of the alkaloids (quinine 
or cinchona) derived from it. Quinine is the remedy 
most used. 

An excellent plan is to give two or three grains of 
quinine four or five times a day between the chills. 
It is best taken in powder mixed with some scraped 
apple, which will disguise its bitter taste. The use 
of the quinine should be continued for some weeks, in 
smaller doses, after the chills have ceased to reappear. 
Every spring and fall, for some years afterwards, a few 
weeks' course of quinine, two grains three times a day, 



1036 ON FEVERS. 

should be gone through with, to guard against a re- 
turn of the disease. 

"We recommend, to those who find quinine disagree- 
able, the use of the antiperiodic mentioned on page 
779. It will be found equally efficacious, and more 
pleasant. 

Common salt has a reputation in this disease (see p. 
703); so also has the American poplar (p. 726), the 
dogwood (p. 729), oak-bark (p. 730), the persimmon 
(p. 731), the willow (p. 735), and parsley (p. 742). 
lS~one of these remedies has, however, the power 
over the disease possessed by Peruvian bark and the 
chemical preparations derived from it. We mention 
them in order that they may be resorted to when the 
latter cannot be had. 



typhoid fever. 1037 

Typhoid Fever. 

This is a fever characterized by great prostration 
of the strength. Peculiar rose-colored spots appear 
from the eighth to the twelfth day of the disease, on 
the skin, particularly of the belly. There are pains 
in the bowels and diarrhoea, which set in early in the 
affection and increase as the disease advances. 

Typhoid fever is known in some parts of the United 
States as the autumnal or fall fever. It has also re- 
ceived the names of putrid fever, gastric fever, gastro- 
bilious fever, and night-soil fever. 

The causes of typhoid fever are contagion, bad air, 
and the effluvia from decaying animal matters, from 
foul drains, water-closets, etc. The drinking of water 
contaminated by sewage is a cause not unfrequently 
active in badly regulated cities. 

The disease is not powerfully contagious; still, there 
is no doubt that under favorable circumstances it is 
often communicated from one person to another. 

It is especially apt to attack the young and those 
in early middle life. 

For fuller statements in regard to the causes and 
prevention of typhoid fever, see p. 248. 

In the United States army during the late war, the 
chief causes of typhoid fever were animal exhalations 
and privy gases. Dr. Bartholow states, in the United 
States Sanitary Commission's Memoirs of the War, that 
" the cases of fever occurred most numerously where 
the diarrhoeal discharges were most abundant, and 
were most exposed to decomposition and dissemination 



1038 ON" FEVERS. 

by the air and water supply. Diarrhoea was common. 
Badly constructed sinks within a few yards of the 
camp were the rule, and not unfrequently no sinks 
were used, but the environs of the camp were con- 
verted into a general latrine. Privy odor was soon 
developed, and the drinking water contaminated. 
"When sufficient time had elapsed, typhoid fever de- 
clared itself." 

THE SYMPTOMS 

May show themselves suddenly by vomiting and purg- 
ing, so as to give rise to the suspicion of poisoning. 
Ordinarily, however, for several days before the attack 
fairly begins, the patient is languid, complains of pain 
in the limbs, and is out of sorts. The fever is ushered 
in with chilliness or profuse diarrhoea. The diarrhoea 
increases, and pain in the bowels becomes troublesome. 
The hearing becomes dull, and the patient has ringing 
in the ears. The face has an anxious and besotted 
expression. Not unfrequently there is bleeding at the 
nose during the first week. The fever and thirst are 
severe. The belly enlarges, and is painful on pressure. 
Somewhere from the eighth to the twelfth day a 
characteristic eruption of rose-colored spots appears 
upon the skin, particularly of the belly. During the 
third week the bowels become more distended, the 
diarrhoea and thirst increase. 

The average duration of the disease is about twenty- 
three days. In fatal cases, death usually occurs to- 
wards the end of the third week ; in favorable cases, 
gradual recovery usually begins during the fourth 
week. 



TYPHOID FEVER. 



1039 



Recovery from this disease is very slow, and beset 
with dangers. The greatest care in the diet and mode 
of life is required to prevent a dangerous relapse. 

No ONE IS PIT FOR HIS ORDINARY WORK FOR THREE 
OR FOUR MONTHS AFTER AN ATTACK OF SEVERE TY- 
PHOID FEVER. 



THE TREATMENT. 

Sponging the skin with a cold or warm mixture of 
vinegar and water, is of service in reducing the fever 
and lowering the pulse. The headache, which is so 
troublesome a symptom in the early stages of the dis- 
ease, is relieved by the free application to the head of 
ice- water, spirits and water, vinegar, or cologne-water, 
or of pounded ice in a bladder or bag. It is better at 
the outset of the affection to cut the hair close, in 
order to render the patient more comfortable during 
the illness. 

Lime-water, mixed with an equal quantity of milk, 
is an excellent drink to restrain the excessive diar- 
rhoea. It is not right to arrest the diarrhoea entirely 
by astringents. 

Hygienic measures, and supporting treatment by 
tonics and nourishing food, constitute the principal 
means of managing a case of typhoid fever. An 
abundance of fresh air, perfect cleanliness, the keep- 
ing of the sick-room at a temperature not above 60°, 
and frequent changing of the posture of the body, 
are essential to good nursing in this disease. With- 



1040 ON FEVER. 

out this intelligent care of the patient, little can be 
accomplished by medication. 

Ice-water or lemonade, barley-water acidulated with 
orange-juice, and soda-water, are pleasant and safe 
drinks, provided too much be not taken at one draft, 
so as to distend the stomach. 

The diet should be nourishing and administered 
often, but in small quantities at a time. No solid 
food should be allowed during the illness, nor for 
weeks after entire recovery has taken place. Death 
frequently results from an ignorance or disregard of 
the danger to the patient of allowing him other than 
a fluid diet. He should be supported on beef-tea, beef- 
essence, and the various animal soups and broths for 
which w r e have given receipts in the chapter on " Re- 
ceipts for the Sick-table." 

As to medicines, an excellent treatment is by qui- 
nine, two grains three times a day. The mineral acid 
treatment is a very popular one at present. Twenty 
drops of dilute nitro-muriatic acid should be given in 
water three or four times a day. 

An approved method of treatment is the following : 
Give the patient fifteen drops of dilute muriatic acid, 
in a wineglassful of water, every two hours, and a 
wineglassful of beef-tea in the alternate hours, so that 
each hour, when awake, the acid or the tea will be 
taken. 



TYPHUS FEVER. 1041 



Typhus Fever. 



This disease, known also as jail fever, ship fever, 
and hospital fever, is caused by overcrowding and bad 
ventilation; it is, therefore, the accompaniment of 
poverty and of overfilled jails, ships, and hospitals. 

It is very contagious, and, in this way, may be 
communicated to those who would never themselves 
have been exposed to the causes which generate it. 

THE SYMPTOMS 

Of typhus fever are great dryness and heat of the 
skin, constipation, a dull, heavy look, much prostration, 
and irritability and restlessness during the evening 
and night. There is severe headache during the first 
week, and often deafness. The wakefulness* at night 
is a troublesome symptom, and the great bodily weak- 
ness one of the most remarkable symptoms. The 
strongest man in health, after a few days' illness with 
this disease, is unable to turn himself in bed. After 
the first week the patient becomes delirious, frequently 
wildly so. 

Convalescence is very gradual. The improvement 
begins between the tenth and sixteenth days. "When 
the disease terminates fatally, death occurs ordinarily 
between the twelfth and twentieth days. 

Typhus fever is distinguished from typhoid fever by 
the peculiarity of the rash, which is called a mulberry 
rash from its appearance; in typhoid fever the erup- 
tion consists of rose-colored spots. In typhus fever, 



1042 OK FEVERS, 

the bowels are constipated; there is rarely diarrhoea, 
and never any hemorrhage from the bowels : in typhoid 
fever, diarrhoea is an early and constant symptom, and 
hemorrhage from the bowels occurs in about one case 
out of twenty-three. 

The treatment of typhus fever is essentially the 
same as that of typhoid — (which see) — consisting in 
good nursing, and measures to support the strength. 



yellow fever. 1043 

Yellow Fever. 

This fever is one which occurs only once during 
life. It is characterized by yellowness of the skin 
and of the whites of the eyes, and is confined within 
certain geographical limits, no case having ever been 
known to originate beyond 48° north latitude, nor at 
a temperature lower than 72°. 

In the western hemisphere, the disease is chiefly 
confined to the seaport towns of the Atlantic coast 
south of Charleston, S. C, on the Gulf of Mexico, and 
in the "West India Islands. There have been several 
severe epidemics of it in some of the more northern 
States.. It made its appearance in Philadelphia in 
1699 and 1740, and again in that city, New York, 
and some other northern cities in 1744, 1747, 1760, 
and 1762. A dreadful visitation of the yellow fever 
afflicted the city of Philadelphia in 1793. " Such was 
the magnitude of this awful calamity, as to excite, in 
the breasts of all classes of people, the keenest emo- 
tions of sympathy and commiseration. The city was 
abandoned by a large proportion of its inhabitants, 
and those who remained were not sufficient to admin- 
ister comfort to the sick, and to bury the dead. It 
was not uncommon for persons to expire alone in a 
house, and without a human being to witness the 
awful scene. A negro, leading a horse and hearse, was 
to be seen in every street, and at almost every house. 
If a solitary passenger was met, his gloom and ghastly 
visage proclaimed the horrors of his soul, as if con- 
scious that with every breath is mingled the sting of 



1044 ON FEYERS. 

death. No less than four thousand and forty-four per- 
sons fell victims to this destructive epidemic in that 
ill-fated city, between the first of August and ninth 
of October. 

At various times other cities of the United States 
have been visited by epidemics, more or less severe, 
of this disease. A singular feature of yellow fever is 
that the negro race is nearly exempt from the liability 
to it, and when attacked the disease with them is very 
mild and attended with little danger. 

Age does not affect the susceptibility to the disease. 
All periods of life, from early infancy to old age, are 
liable to it. There are more cases among men than 
women. 

Yellow fever is essentially a disease of warm cli- 
mates. A continuous temperature of over 72° for 
several weeks at least is necessary for its development. 

Although the fact whether yellow fever is conta- 
gious has been questioned, the evidence in favor of its 
contagiousness is, in our opinion, conclusive. We 
warn our readers against the danger of a contrary 
opinion. 

In localities in which the disease often prevails it 
may be frequently prevented by sanitary regulations, 
such as the removal of filth, the avoidance of over- 
crowding, attention to drainage, sewerage, etc. In 
localities in which the disease rarely shows itself it 
may be prevented by a rigorous quarantine. 



YELLOW FEVER. 1045 



THE SYMPTOMS 

Of yellow fever are, the suddenness of the attack, often 
appearing in the middle of the night; the yellowness of 
the skin and of the whites of the eyes; the severe pain in 
the front of the head, the back, loins, and calves of the 
legs; the great feebleness of the mind and body; and 
the irritability of the stomach. After a while the 
matter vomited has the appearance of coffee-grounds, 
constituting what is called the black-vomit. There is 
apt to be bleeding from the bowels, nose, and gums. 

The fever ordinarily lasts from three to seven days, 
although the patient may die in a few hours. If the 
patient passes the sixth day without black-vomit, the 
case is progressing favorably. 

THE TREATMENT 

Of yellow fever is difficult and unsatisfactory. The 
diet should be simple. Ice swallowed in small pieces 
relieves the irritability of the stomach. 

The patient should go to bed at once, so soon as 
attacked — complete rest of body and mind is of pri- 
mary importance. Cleanliness, plenty of pure air, and 
all the other sanitary resources which we have dwelt 
upon in the second part of this volume, in treating 
of the nursing of the sick, are of more value than any 
of the preparations of the apothecary — for no specific 
for the disease is known. 

Foot-baths under the bedclothes, and sponging the 
body frequently with warm water, are of great advan- 



1046 



ON" FEVERS. 



tage. Medicines to induce perspiration, such as sweet 
spirits of nitre or spirits of mindererus, are also of 
service. But the care of the person and chamber of 
the patient, which a skilful nurse alone can give, is, we 
repeat, of the greatest moment. In New Orleans the 
Creole nurses manage with much success many cases 
of yellow fever without any medical aid. 





CHAPTEE XII. 

DISEASES OF CHILDREN. 

Measles — Scarlet fever — Chicken-pox — Mumps — Whooping-cough — True 
croup — False or spasmodic croup — Diphtheria — Thrush — Summer com- 
plaint, or cholera infantum — Wasting disease — Rickets — Worms — Bed wet- 
ting. 

OME of the most frequent diseases of children 
are characterized by fever and an eruption. 
The diseases of this class are, measles, scarlet fever, 
chicken-pox, and smallpox. The last mentioned we 
have already spoken of. They are all contagious or 
catching; all accompanied by fever; all attended by 
an eruption or breaking out on the skin, and in all a 
certain time elapses between the exposure to the 
poison which causes them and the onset of the dis- 
ease. It is often difficult at the commencement to 
say which of them we have before us, and hence the 
following points of difference are well to bear in 
mind : — 

Measles attacks a person ten to fourteen days after 
exposure; the eruption appears on the fourth day of 
the fever, and fades on the seventh day. 

Scarlet fever attacks four to six days after exposure; 
the eruption appears on the second day and fades on 
the fifth day of the fever. 

( 1047 ) 



1048 DISEASES OF CHILDREN. 

Smallpox attacks twelve days after exposure ; the 
eruption appears on the third day, scabs form on the 
ninth or tenth day, and fall off about the fourteenth. 



MEASLES. 

Measles commences with a feeling of weakness, 
_oss of appetite, some fever, and a cold in the head 
and throat. The eyes are watery, sneezing frequent, 
a dry cough, and a hot skin. 

The eruption comes out at the end of the third or 
the beginning of the fourth day. It consists at first 
of small round spots like flea bites, which gradually 
run together to form blotches. They are of a dull, 
dingy red color, in shape often resembling a crescent 
or horse shoe, and slightly raised above the surface of 
the skin. This rash appears first on the forehead and 
face, and gradually extends downward. The fever 
does not diminish when the rash comes out, but may 
continue several days. The most dangerous symp- 
toms of the disease are those which point to the lungs, 
as these organs not unfrequently become inflamed. 
The greatest care should, therefore, be exercised that 
the patient does not take cold. Exposure must be 
avoided. The patient should be kept in bed in a 
moderately warm room. The diet should be light, 
but nourishing. Much medicine is not required. The 
bowels may be opened by a small dose of oil or a glass 
of Congress water, but this must be done carefully, as 
an obstinate diarrhoea sometimes sets in. For a child 



SCARLET FEVER. 1049 

six years old the following recipe will be found useful 
in reducing the cough and the fever : — 



Take of— 

Sweet spirits of nitre, two teaspoonsful, 

Paregoric, one teaspoonful, 

Camphor water, a wineglassful. 
Mix, and give a teaspoonful in a wineglass of water 
every two hours. 



Black measles or camp measles was not uncommon 
during the late war. It is simply a severe variety of 
the ordinary disease. (See also pages 369, 414.) 



SCARLET FEVER. 

This disease is called by physicians scarlatina, al- 
though the public often suppose that the latter term 
means a very light form of the disease, which is incor- 
rect. It is justly feared, as, in its severer forms, it is 
one of the most fatal diseases to wdiich children are 
subject. It is extremely contagious. Instances have 
been known where it was conveyed by clothing which 
had been laid aside for a year, and others where the 
poison lurked in a room in spite of cleansing and 
purifying, and attacked new residents three to four 
months afterwards. 

The attacks vary greatly in severity. In the 
lightest form the skin only is affected, a slight rash 
or redness is visible, but the child hardly appears 
sick, and often continues to run about with little in- 
convenience. Generally, however, there is a decided 



1050 DISEASES OF CHILDREN. 

fever and headache, with a feeling of weakness. The 
eruption appears early, on the first or second day, 
commencing about the neck, face, or chest, in the form 
of numerous red elevated points, which disappear on 
pressure with the finger, but return when the pressure 
is removed. Its color is a bright scarlet, most dis- 
tinct about the loins. In severe cases it may assume 
a dull, bluish, dusky appearance. After four or five 
days the skin separates in the form of scurf or branny 
scales. The pulse is quick, and the surface of the 
body hot to the touch. The tongue is at first covered 
with a thick white fur, but later becomes unnaturally 
red, and of a strawberry appearance. 

One of the distinguishing features of scarlet fever 
is the sore throat. This is always present except in 
the mildest cases. There is stiffness of the neck, 
hoarseness, pain in swallowing, and redness and swell- 
ing of the interior of the throat very perceptible on 
examining it. In the more dangerous varieties of the 
disease, the throat symptoms are the most prominent 
and painful. It may not be much swollen but is dusky 
red, covered with a dark, foul smelling coat, the tongue 
dry and brown, and great difficulty in speaking or 
swallowing. In these malignant cases the rash is 
irregular in the time of its appearance, it may remain 
only for a few hours, and then disappear, leaving the 
skin rough and with a kind of nutmeg grater feel to it. 

After the first severity of the attack is over, children 
are very liable to have their health permanently effected 
by some of the consequences which result from it. 
Abscesses about the throat may occur ; severe and ob- 



SCARLET FEYER. 1051 

stinate coughs may set in ; but the most common re- 
sult is dropsy. It comes most frequently within a 
week or two after the skin commences to flake off, that 
is about three weeks from the commencement of the 
sickness. Many physicians believe that this dropsy 
is always the consequence of some exposure to cold. 
The greatest caution should therefore be exercised 
lest some act of carlessness should give occasion for 
this troublesome sequel. 

The treatment of scarlet fever in its milder forms is 
very simple. Confinement to the house, keeping the 
bowels moderately open, and a judicious diet include 
all that is requisite. In the severer forms sponging 
with tepid or cool water is often agreeable and bene- 
ficial. Or the skin may be rubbed with suet, goose- 
grease, or bacon fat, which relieves the intense burning 
heat. For the throat, the early, free, and abundant 
use of cold water, and ice, internally and externally, 
cannot be too highly recommended. The child should 
be given pieces of ice to suck, and cold water to drink; 
its throat should be kept wet with rags wrung out 
every few minutes in ice water, or still better by apply- 
ing a bladder partly filled with small pieces of ice to 
the throat; and the skin may be freely sponged with 
cool water. Ice cream is grateful and healthful, com- 
bining the cold with nourishment, and may be freely 
given. 

The hot and fiery gargles containing red pepper, 
mustard, turpentine, and nitrate of silver, sometimes 
prescribed, should be avoided. So should wrapping 
the throat in hot cloths. The chamber should be well 



1052 DISEASES OE CHILDREN. 

ventilated and maintained at a moderate warmth. As 
a gargle, water can be used to which as much chlorate 
of potash has been added as it will dissolve. Such a 
gargle should be employed frequently, every hour or 
half hour, when the patient is awake, to be of much 
service. 

The diet should be liquid but nourishing. A ten- 
dency to weakness is manifested early, and it must be 
met by giving mutton and chicken broths, milk or 
milk punch, soft eggs, and beef-tea. 

At the end of the third week precautions must be 
taken lest the dropsy sets in. Lemonade should be 
freely used as a drink if the urine be scanty. "Water 
with cream of tartar and sugar will also be a useful 
beverage. Six or eight grains of quinine may be 
given in grain doses for several days if any swelling 
begins. (See also page 414.) 

CHICKEN-POX 

Is a disease of little danger, arising from contagion. 
Four or five days elapse after exposure before it 
begins. Then usually there is a slight fever and sense 
of general sickness followed within twenty-four or 
thirty-six hours by the appearance of pimples scattered 
over the skin, itching and heat. In the second day 
these pimples change into little blisters filled with a 
watery fluid. After i^ve or six days, they fade away, 
usually leaving behind them no trace of their presence. 
Little need be said as to the treatment, as nothing 
but judicious nursing is required. The bowels should 
be maintained in regular action, the child should be 



MUMPS. 1053 

guarded against cold, and prevented from scratching 
the skin when the eruption is drying up. 

MUMPS 

Is a common disorder of childhood after the fifth or 
sixth year. It consists in a contagious inflammation 
of the glands situated on the side of the face in front 
of the ear. It begins with a slight fever, followed at 
the end of twenty-four hours by stiffness of the neck 
and lower jaw, and a swelling and soreness of the 
gland. Sometimes this extends below and in front of 
the ear, along the neck to the chin, so that the entire 
throat and face is greatly swollen. Usually the dis- 
ease reaches its height in four or five days and then 
begins to decline, but sometimes it is more tedious in 
its course. Occasionally the swelling and inflamma- 
tion disappears from the face and transfers its seat to 
the breasts in girls or the male glands in boys. 

The treatment should be commenced early by ap- 
plying to the swelling a large hot mush and hop poul- 
tice, whicli should be changed for a fresh one every 
few hours. Cold and exposure should be guarded 
against, and the diet at the outset be plain and low. 
"When the swelling continues for some time, and does 
not seem inclined to diminish, its surface may be 
advantageously painted with tincture of iodine, and 
stimulated with gentle rubbing. Some mild laxative 
may be given to keep the bowels open, if it is de- 
manded. 



1054 DISEASES OF CHILDREN. 



WHOOPING COUGH. 



This is a very frequent disease in children, and it 
also occurs in adults, and even quite elderly persons, 
though rarely more than once in the same individual. 

It usually commences with the symptoms of a com- 
mon cold in the head. There is some chilliness, fol- 
lowed by feverishness, restlessness, headache, a feeling 
of tightness across the chest, and a troublesome cough. 
These general symptoms disappear in a few days, but 
the cough continues, and becomes peculiarly hard, 
dry, and severe. It comes on in paroxysms, so violent 
that they threaten to exhaust and suffocate the patient. 
The eyes start forward, the nose may bleed, and, after 
the convulsive cough ceases, the air rushes into the 
lungs with a peculiar crowing or " whooping" noise, 
from which the disease takes its name. As has been 
remarked, however, this " whoop" is the signal of the 
child's safety, showing that the paroxysm is over and 
the sufferer about to breathe naturally. It is, in a 
great measure, a good sign to hear it, for those cases 
are always the most severe in which with many and 
severe fits of coughing little or no whooping occurs. 

The whoop may first appear within three days from 
the onset of the fever, but it varies much, and some- 
times it is as many weeks. The cough is always 
more severe at night, and exposure to cold will nearly 
always brings it on. 

The disease is rarely fatal, and death almost only 
occurs when some other complaint, such as inflamma- 



TRUE CROUP. 1055 

tion of the lungs or scrofula, is associated with the 
cough. More female than male children die from it, 
and more in winter than in summer. 

There have been so many remedies recommended 
for it that we are right in considering that none of 
them always effects a cure. One of the best, and at 
the same time cheapest and handiest, is "alum lemon- 
ade." It is thus prepared: Take a teaspoonful of 
powdered alum, stir it in a tumbler of water, add a 
teaspoonful of syrup, a little of the juice and some of 
the peel of a lemon, or else flavor it with a few drops 
of the essence of ginger; of this let the child take a 
tablespoonful every two or three hours, in proportion 
as the cough is troublesome. 

Another convenient remedy is the tea drawn from 
the leaves of the chestnut tree. It should be sweet- 
ened to the taste, and given to the child as its regular 
drink. The tops of red clover, fresh or dried, when 
used in the same w T ay, also exert a curative influence 
on the cough. "When the spasms are severe, the vapor 
from slacking lime, as described on page 708, will be 
found very useful in checking them. The child must 
be carefully protected from cold and damp, and it 
must be seen to that it does not throw off the bed- 
clothing at night, and thus become chilled. 

TRUE CROUP. 

The disease commonly known as croup, includes 
two very different complaints, one of which is very 
dangerous, the other hardly ever so; the former is 



1056 DISEASES OE CHILDREN. 

known as true croup, the latter as false croup, or 
spasm of the larnyx. The former is an inflammatory, 
the latter a nervous affection. 

A case of true croup commences with the symptoms 
of a common cold. There is slight fever, thirst, a 
hard, hollow cough, hoarseness, drowsiness, watery 
eyes, and running at the nose. These continue about 
thirty-six or forty-eight hours, when the second stage 
of the disease sets in. The child is suddenly awoke, 
generally at night, with short, quick, and difficult 
breathing, choking, and a hard, dry, ringing, "croupy" 
cough, attended with a characteristic crowing noise, 
not easily mistaken when once it has been heard. 
The child is distressed and restless, and obtains no 
relief till toward morning, when the symptoms abate 
a little. But soon the fever increases, the breathing 
becomes more labored, the thirst is great, the voice 
grows very hoarse, the tongue is coated with a 
thick fur, the child throws its head back and clutches 
at its throat in its efforts to breathe, and its suffering 
is marked in every feature. Often it refuses to speak, 
and turns away from all food. Unless relief is 
promptly afforded, the fits of coughing and choking 
increase in frequency, but the cough becomes more 
difficult and strangulating. The voice can hardly be 
heard, while the crowing, croupy breathing is constant. 
The child struggles and gasps in the greatest agony, 
clutches at articles around, and perishes, choked to 
death. Such is the real cause of death ; for examina- 
tion of the body shows that the disease deposits a 
tough substance around the sides of the windpipe, 



FALSE OR SPASMODIC CROUP. 1057 

adding to it more and more until the air can no longer 
be drawn into the lungs, and the child dies in the same 
manner as if its little throat had been seized by the 
iron grasp of a murderer. 

Prompt and cautious treatment here is of the utmost 
importance. Even when an attack of croup is merely 
feared, the child having a cold and a ringing cough, 
we should place him in a warm bath for ten or fifteen 
minutes, confine him to bed, keep the air of the cham- 
ber moist by the steam from boiling water, allow only 
a spare diet, and give him an emetic, syrup of ipecac 
for instance, or alum (see page 699), or Canada snake 
root. As mentioned on page 396, a morning bath is 
often a preventive when properly given. "When the 
attack is violent, the proper treatment is to administer 
an emetic as quickly as possible, and, when it has 
acted, to let the child breathe the vapor from slaking 
lime (see page 708), or steam from boiling water, and 
to apply cloths wrung out in hot water to the throat 
and chest (see page 722). A gargle of lime-water 
will aid to relieve the throat. The diet should be fluid 
and nourishing, and the emetic and inhalations re- 
peated every three or four hours, until relief is ob- 
tained. 

FALSE OR SPASMODIC CROUP. 

This is a very common complaint in nervous and 
delicate children, and often causes their parents much 
and unnecessary alarm, from its resemblance to the 
very serious disease which we have just described. It 

67 



1058 



DISEASES OF CHILDREN". 



will be of interest, therefore, for the reader to qualify 
himself to distinguish between the two. The follow- 
ing are their principal peculiar features : — 

In true croup the disease commences with fever of 
more or less severity, a hoarseness which gradually 
and regularly increases, and a cough, at first hoarse 
and ringing, but soon becoming hollow^ and feeble, as 
does also the voice. The fever diminishes but slightly, 
and a tough, shreddy matter is spit up. The difficulty 
in breathing grows worse, the crowing, croupy breath- 
ing persists, and between the fits of coughing the 
child is clearly very sick. In false croup the symp- 
toms at the onset are slight, the throat is not affected, 
and the fever is light. With little or no warning the 
child is seized at night with a hard, dry, barking 
cough, with more or less strangling, some hoarseness, 
and a peculiar crowing breathing. There is no sore- 
ness of the throat, and between the attacks, which 
may occur every night for two or many months, the 
child seems quite well, spits up nothing, and never 
loses his voice. (See page 369.) 

The treatment that these attacks require, is simple. 
A sponge wrung out in hot water and applied to the 
front of the throat will often check the attack ; if it 
does not, an emetic should be given at once (any of 
those described in the last article would be suitable), 
and, after it has acted, a dose of bromide of potassium, 
as many grains as the child has years, should be ad- 
ministered; or five drops of chloroform or ether on 
sugar will be found efficacious; or the inhalation of 



DIPHTHERIA. 1059 

vapor of lime, or of steam from boiling water poured 
over hops will check the spasm. 

Children who are liable to this disease are generally 
of feeble constitution and weak nerves. They re- 
quire, therefore, a nourishing diet, plenty of fresh air, 
and moderate exercise. Fatigue and overexcitement 
should be avoided, and often a course of tonics, iron 
and bark, is required to perfect a cure. But the 
child's stomach must not be overloaded with food, and 
its suj)per should invariably be plain and light. 



DIPHTHERIA. 

Diphtheria strongly resembles a very bad attack of 
true croup; so much so, indeed, that some physicians 
maintain that the diseases are identical, differing only 
in severity. There are, however, some advantages in 
considering them separately. 

In diphtheria there is at the outset great prostra- 
tion, the back part of the mouth and throat are very 
red, the breathing soon becomes difficult, and it is 
evident that the windpipe is becoming stopped up 
with a similar tough matter to that we described 
under croup. The neck and throat swell up, the 
tongue is very red at the tip and edges, with a thick 
fur on the back part, the breath is horribly offensive, 
and there is a good deal of running from the nose and 
eyes. "When the patient recovers he is often attacked 
during convalescence by dropsy, palsy, or disease of 
the kidneys. 

The general treatment is somewhat similar to that 



1060 



DISEASES OF CHILDREN. 



of croup ; no emetics are needed, however. A gargle 
of lime-water or chlorate of potash (a teaspoonful to 
a tumbler of water) is useful ; a few drops of pure 
carbolic acid added to it will greatly assist in remov- 
ing the bad odor of the breath. Ice may be taken 
into the mouth in small pieces, and. a bladder with ice 
to the outer surface of the throat is often very agreea- 
ble and beneficial. Inhalations of lime vapor should 
not be neglected. The patient must have strong beef 
tea, mutton broth, milk punch, or eggnog early and 
freely, as the chief danger is from exhaustion. For 
other remedies the reader will see pages 708 and 709. 



THRUSH. 

This affection of the mouth is common in young 
infants, especially in those who are artificially fed, or 
who are suckled by an unhealthy nurse. 

A child suffering from it is fretful and peevish, 
refuses its food, and has loose and irregular bowels. 
On looking in its mouth we find the surface studded 
with numerous small white spots looking like specks 
of curd, which are most abundant on the inside of the 
lips, the inner surface of the cheek, and on the tongue. 
These specks fall off, but others quickly take their 
places. The remainder of the surface looks dry, red, 
and hot; there is fever, weakness, and swelling of the 
lips, increasing if the disease grows alarming. Death 
from exhaustion occasionally ensues. 

In mild cases careful attention to the diet will often 
be sufficient to effect a cure, as improper feeding is 



SUMMER COMPLAINT. 1061 

the commonest cause of the complaint; cleanliness, 
good food, pure air, and careful nursing are essential. 
As regards local treatment, the best and simplest 
application is to rub up a teaspoonful of powdered 
borax with two tablespoonsful of honey or clear syrup, 
and apply this to the inside of the mouth three times 
a day with a camel's hair brush ; or, if the child 
opposes this, simply placing a little of the mixture in 
the mouth from time to time will suffice. Chlorate of 
potash may be used instead of borax. A few grains 
of magnesia every other day will suffice to regulate 
the bowels. 

SUMMER COMPLAINT, 

Or cholera infantum, a frequent and fatal disease in 
this country, occurs generally in children under three 
years of age, especially in the summer and abotft the 
period of teething. The child is seized with vomiting 
and purging, the latter usually occurring first; he is 
very thirsty, but everything is rejected from the 
stomach ; great weakness ensues, severe pain often 
seems to be present ; he sinks into a stupor ; and 
death may close his short life in twenty-four or forty- 
eight hours. Or the attack may be prolonged, the 
vomiting and discharges become not so violent, but 
bilious and watery, the appetite disappear, colicky 
pains come and go, the child waste away, become 
dull and peevish after weeks of suffering. Children 
of the poorer classes, in cities, who have improper 
food and live in unhealthy dwellings, are the most 



1062 DISEASES OF CHILDREN. 

frequent victims. Infants brought up by hand are 
peculiarly exposed to such attacks, and those generally 
who suffer from a lack of intelligent care. 

The treatment must in the first place be directed to 
put a stop to the vomiting and purging. For this 
purpose, a large mustard plaster should be spread, 
and laid over the stomach and bowels; and a tea- 
spoonful of the following mixture should be given 
with an equal quantity of milk every half-hour till 
the vomiting is checked. 



Take of— 

Creasote, one drop. 

Liine-water, wineglassful. 
Mix theni. 



Sometimes, when this fails, a few grains of baking 
soda dissolved in a little water will succeed; or small 
pieces of ice may be given the child to swallow; or 
flannel wrung out in hot water and sprinkled with 
laudanum, may be applied to the spine; or the little 
patient may be placed for three minutes in a warm 
bath and then quickly dried and wrapped in flannel. 
Food should be given as soon as the stomach will 
tolerate it. Milk and lime-water to which a little 
rennet whey has been added will often be borne early. 
But in obstinate cases where there is much weakness 
the "raw meat diet" should be commenced, in the 
manner which we have already described on page 409. 
~No milk should be given except mixed with lime- 
water, or a little soda added to it. 

The child should be confined to bed and kept lying 



WASTING DISEASE. 1063 

down during the earlier part of his sickness ; he must 
be protected from cold, and all those precautions 
taken which we have so fully dwelt upon in our 
Chapter on the Nursing of Children. As soon as the 
infant can bear to travel, it should be removed from 
the city and its unhealthy surroundings to some 
salubrious point either on the sea-shore or to a cool and 
mountainous region. This measure, if not deferred 
too long, rarely fails, and it should be resorted too as 
soon as possible, if other means do not promptly bring 
about a cure. If it is not practicable, the child 
should be in the open air as much as possible, and 
should be carried daily as far from home as is 
convenient, in order, in this way, to secure a change of 
air. Hope of recovery should not be relinquished, no 
matter how desperate the case appears, as not unfre- 
quently the most unpromising cases recover after 
lingering long on the verge of the grave. 

WASTING DISEASE. 

There is a painful and fatal disease quite common 
among neglected and naturally feeble or consumptive 
children called marasmus, or wasting sickness. It 
commences usually between the first and second 
teething. There is more or less constant and some- 
times severe pain in the bowels, causing the child to 
keep his legs drawn up towards his belly. The lips 
are red and the corners of the mouth cracked and sore. 
The bowels are irregular, generally loose and watery. 
The belly is swollen, puffed up, and hard to the touch ; 



1064 DISEASES OF CHILDREN. 

the other parts of the body waste away to an extreme 
degree of emaciation, with increasing weakness. The 
diarrhoea increases, and the child generally dies 
exhausted. 

Recovery, however, does occasionally occur, so 
treatment should be commenced promptly and pursued 
hopefully. There should be a mild non-nourishing 
diet adapted to the child's health and strength. Cod- 
liver oil will be of much use in all cases. Change of 
air should be sought early. The seaside should be 
preferred, and warm or tepid sea-water baths should be 
used several times a day, with plenty of fresh air and 
good animal food. The period of convalescence is 
long; and great caution will be required during its 
progress to avoid relapses, and exposure to contagious 
diseases, which would be very dangerous to a child in 
such a condition. 

RICKETS. 

This is a disease of the bones which appears in 
scrofulous children, and impresses upon them a pecu- 
liar and ungainly shape, feeble muscular power, and 
often mental deficiency. The head is unusually large, 
flat, and square, the chest wide, and flattened, the 
limbs more or less bent, the stature short, and the skin 
with a thick muddy look. The child is dull and lan- 
guid, lacking in spirit, appetite poor, some diarrhoea, 
with a hot, dry, and tender skin. The teeth appear 
tardily, and the change in the shape of the bones soon 
shows, beyond a doubt, what is the nature of the dis- 
ease. 



WORMS. 1065 

As we have intimated, this malady is essentially one 
of the forms of scrofula; and it must be treated on the 
same principles as that disease demands. These we 
have fully explained on page 791, to which we refer. 

WORMS. 

Children are very liable to disorders of various kinds 
which, however diverse in appearance, have a common 
cause in the presence of worms in the bowels. Most 
of these worms belong to one of three varieties. The 
first variety is the " thread worm." This has a very 
slender body, of a whitish color, resembling a piece of 
thread. Some of them are tw T o inches in length; 
others, known as "seat worms," not more than a 
quarter of an inch. The latter are usually found 
about the extremity of the bowel, and give rise to in- 
tolerable itching. Other symptoms of their presence 
are irritation and pain at stool, picking at the nose, a 
foul breath, a desire to eat dirt and refuse, a capricious 
appetite, starting in the sleep, gnashing of the teeth 
at night, and general restlessness. 

The second variety is the "round worm." It is 
found especially in ill -fed children between three and 
ten years of age. Occasionally it makes its way out 
of the mouth, and is often passed at stool. It some- 
what resembles in size and shape the common earth 
worm, and varies in length from six to nine inches, 
being of a light yellow color. The symptoms which 
it may give rise to are similar to those produced by 
the thread worm, the belly being more swollen, greater 



1066 DISEASES OF CHILDREN". 

emaciation, the stools slimy, and the breath offensive. 
When they are numerous, fits or convulsions may 
arise from them, or a slight fever may set in, or they 
may cause dyspepsia and appearance of wasting. 

The tapeworm is also found in children. It is very 
long, sometimes twenty or thirty feet, and is made up 
of a number of joints about half an inch in length, not 
quite so wide, and flat. These it can cast off from 
time to time, but is not itself dislodged until the first 
joint or segment, which contains its head and hooks 
for holding on, are brought away. The symptoms of 
its presence are not very striking, being generally an 
unnatural appetite, a continued desire to eat, weak- 
ness, pain in the bowels, loss of flesh, indigestion, and 
itching at the nose or anus. If the passages from the 
bowels are closely examined, some joints will be found 
among them, which puts the presence of the animal 
beyond doubt. 

These creatures are not spontaneously produced in 
the bowels, as people once believed, but their eggs 
are taken into the stomach by drinking impure water, 
eating the flesh of animals not sufficiently cooked, or 
other food in which their germs are concealed. Raw 
ham or pork, and raw or very rare meat generally, is a 
fruitful source of them. 

Some of the symptoms of the different species we 
have just mentioned. We may add that generally the 
presence of worms maybe suspected when the child 
has irregular diarrhoea and vomiting, a slightly coated 
tongue; the skin of a grayish muddy color; the white 
of the eye glistening, the pupil dilated, and a dark ring 



WORMS. 1067 

under the eyelid, the belly swollen and hard, appetite 
changeable, and hiccough frequent; fretfulness, picking 
the nose, and restlessness at night. With these symp- 
toms, the child loses flesh, grows weak and listless. 
He may have fits, an obstinate cough, and considerable 
colic from this cause. Positive proof is when some of 
the worms are passed in the stools ; and this should 
always be carefully looked after when we suspect their 
presence. 

The treatment of worms requires attention to two 
points — their destruction, and the restoration of the 
general health. For seat worms the most effectual 
treatment is an injection of strong brine (an ounce of 
salt to a pint of water, one-quarter of this every morn- 
ing). For round and tapeworms the oil of turpentine 
(ordinary spirits of turpentine) is one of the most use- 
ful remedies. We have given directions for its use, 
page 719. Worm-seed (see page 747) is also effective. 
The vermifuge we have included in the Standard Re- 
medies, composed largely of santonine, is likewise 
excellent. 

When by some of these means the animals are ex- 
pelled, tonics should be given to restore the strength 
and prevent their return. The child should also be 
directed to take plenty of salt with his food, and to 
avoid the use of pork and imperfectly cooked meats. 
Some laxative medicine, castor oil or magnesia, should 
be given once or twice a week, and the child encour- 
aged to exercise actively in the open air. 



1068 



DISEASES OF CHILDREN. 



BED WETTING. 



Young children often suffer from a want of power 
to retain their water, especially during sleep. This 
may come from some serious disease of the bladder or 
kidneys, but, in the large majority of cases, it is the 
consequence of bad hygienic habits ; being caused by 
the free use of fluid' during the after part of the day, 
by exposure to cold in the night, by lying on the back, 
and by neglect to empty the bladder before going to 
bed. It may also be produced by the irritation of 
worms in the bowels, or stone in the bladder. 

The child should be made to abstain from drinking 
for three or four hours before going to bed; he should 
empty his bladder thoroughly the last thing; and if 
required, should be taken up once or twice during the 
night for that purpose. A towel should be pinned 
around his waist with a large knot in it over the back 
bone, so that he cannot roll over on his back. He 
must be well covered, and sleep in a moderately warm 
room. The following prescription may be prepared 
for a child six or eight years old. 



Take of— 

Tincture of nux vomica, 12 drops. 

Syrup of ginger, 

Water, of each half an ounce. 
Mix. Dose, one teaspoonful at night. 



Sometimes a plaster of belladonna about four inches 
square placed just above the buttocks is very useful. 



CHAPTEE XIII. 

DISEASES OF THE SKIN AND KIDNEYS. 

How divided. I. Discolorations of the skin — Sunburn — Tan — Freckles — 
Liver spots. II. Diseases marked by pimples or wheals — Red gum or 
tooth -rash — Nettle rash — Hives and prickly heat — Camp itch, soldier's itch, 
or ground itch. III. Diseases with a watery discharge — Moist tetter, 
milk crust, scald head, or barber's tetter — Fever blisters — Poison vine 
eruption. IV. Diseases characterized by matter or pus — Rosy drop or 
face pimples. V. Diseases marked by dry scales — Dry tetter — Leprosy. 
VI. Diseases of mixed characters — Itch — Ringworm — Barber's itch. VII. 
Diseases of the kidneys and bladder — Diabetes — Blight's disease — Gravel — 
Inflammation of the bladder. 




ISEASES of the skin are very common in some 
parts of the country, and as one who suffers 
from them is rarely forced by their severity to have 
recourse to a physician, it is peculiarly desirable that 
the various means of cure should be set forth in a work 
on the home treatment of disease. 

They differ much in appearance and severity. Some 
are " catching," and some are not. Some itch violently, 
some not at all. And most of them are obstinate and 
slow in healing. If one examines them carefully, it 
will be seen that they can be divided into five classes, 
readily distinguished. There are first, various discolo- 
rations of the skin, a rash, blush or dark spot, as in 

( 1069 ) 



1070 DISEASES OF THE SKIN. 

sunburn, tan or freckles ; secondly, hard raised spots, 
"wheals" or " pimples," can be felt and seen on the sur- 
face of the skin ; thirdly, minute blisters are percep- 
tible, which break and cause a damp or " weeping" sur- 
face, more or less covered with moist scabs, as in moist 
tetter ; fourthly, the surface of the skin presents the 
appearance of a mattery sore ; fifthly and finally, the 
skin is covered with a dry, branny scurf, made up of 
very small scaly particles of the skin, as in dandruff 
and dry tetter. 

These are the varieties of skin diseases, and if these 
simple appearances are borne in mind it will not be 
hard to recognize what variety we may have before us. 
The only difficulty is that in some these distinctions 
are blended, and we may find several of the peculiari- 
ties mentioned above present on one and the same sur- 
face. This is especially apt to be the case in a limited 
number of common diseases, and we shall therefore 
treat these separately as the sixth or mixed class. 

I. Discoloration of the Skin. 

Sunburn and rose-rash. The former is caused, as 
the name denotes, by exposure to the rays of the sun. 
The skin becomes red and painful to the touch, slightly 
swollen, with sensations of smarting, prickling, and 
burning. "When pressed on, the patches become pale, 
but the redness returns when the pressure is removed. 
Violent rubbing, constant pressure on a part, as when 
a person lies for days in the same position in bed, and 
the friction of parts of the body, as of the thighs, not 



DISCOLORATIOXS OF THE SKIX. 1071 

unfrequently give rise to the same appearance and 
similar painful sensations. The latter occurs fre- 
quently in infants. 

In mild cases all that is necessary is to avoid the 
cause of the trouble ; and to subdue the pain make 
applications of cold water or lead water with a little 
glycerine, as in the following recipe. 



Take of— 

Sugar of Tead a teaspoonful. 

Glycerine .a tablespoonful. 

Water a quart. 
Mix, and bathe the parts every hour. 



Often greasing the part thoroughly with clean fresh 
lard, fresh unsalted butter, or simple cerate will give 
great relief. A teaspoon even full of oxide of zinc 
rubbed up with a tablespoonful of either of these makes 
an excellent ointment. Dusting the parts with pow- 
dered starch or with lycopodium powder is very useful 
where there is moisture of the surface present. Pa- 
tients who are confined io bed for a long period, should 
have any part which suffers protected by water or air 
cushions, as we have previously explained. 

Tan and freckles are brown discolorations, produced 
by the sun's rays. They give rise to no unpleasant 
sensations, and for purposes of health, therefore, require 
no special attention. The attempts often made to 
remove them by secret compounds sold for the purpose 
are usually vain, and may prove injurious. The value 
of lemon juice we have mentioned on page 707. 

Liver spots are dark colored patches appearing fre- 



1072 DISEASES OF THE SKIN". 

quently on the forehead and face. They are so called 
because they frequently result from sluggish action 
of the liver. The. various washes recommended by 
advertisers are of no avail. The only cure is one di- 
rected to general health. Residence at mineral springs 
with sulphurous and saline waters is beneficial. An 
" alterative," such as that we have given among the 
Standard Remedies, will suffice in place of this when 
absence from home is impossible. The diet should be 
chiefly vegetable, the general health must be restored, 
and frequent bathing practised. In women such 
blotches are sometimes connected with womb diseases, 
and will not disappear until these are cured. A tea 
of cleavers, as mentioned on page 729, is sometimes 
successful. 

II. Diseases marked by Pimples or "Wheals. 

RED GUM OR TOOTH-RASH. 

This eruption makes its appearance on infants, and 
is generally connected with some trouble about the 
gums or stomach. It consists of many small red pim- 
ples, close together, and often over nearly the whole 
body. They are attended with itching, and the pim- 
ples appear in successive crops. 

The cause of the complaint is either indigestion from 
unwholesome or unsuitable food, swollen and painful 
gums from teething, the use of too thick clothing, or 
over-hot rooms. 

In its treatment these points must at once be at- 
tended to. The gums should be lanced if they are 



NETTLE RASH. 1073 

swollen, hot, and tender. Cleanliness must be ob- 
served, the child must not be too much wrapped up ; 
the use of soap must be avoided ; the bowels should be 
acted upon by a little magnesia ; and soothing applica- 
tions must be made to the rash. A very useful one 
can be prepared from the following recipe : — 



Take of— 

Carbonate of potassa, twenty grains. 

Glycerine, two drachms. 

Rose water, six ounces. 
Mix, and use as a lotion. 



Starch-powder or lime-water is also agreeable, and 
aids in relieving the distressing itching. We have also 
given on page 527 several lotions for this purpose, 
useful in all cases. 



NETTLE RASH. 

The popular term nettle rash is applied to the rash 
from the stings of nettles, and also to a sudden erup- 
tion of raised red spots, like wheals resulting from the 
blows of a whip. Much burning, stinging, and itching 
attend them. Usually they are preceded by some 
fever, headache, pain at the stomach, and restlessness. 
They readily appear on a spot after scratching. They 
commonly remain only a few days, and then disappear, 
leaving behind no trace of their presence. 

They frequently follow the taking of special articles 
of food, as shell-fish, pork, lobsters, and oysters ; but 
almost any food which leads to an attack of indigestion 



1074 DISEASES OF THE SKIN". 

will produce the rash in persons who are subject to it. 
For, as may be inferred from this, it is very liable to 
recur from time to time ; and, indeed, in such, when 
the constitution is broken down by bad habits or 
attacks of disease, it may assume a chronic form and 
become permanent. 

As it usually arises from disorder of the stomach, 
the treatment should be directed to opening the bowels 
by a Seidlitz powder, some mineral water, or other 
such laxative, confining the patient to a light milk 
diet, and bathing the parts in soda water (an ounce 
of carbonate of soda to a gallon of water). Vinegar 
and water, or starch-powder will be found soothing 
applications to the eruption. Stimulants of all kinds 
must be avoided, and also those articles of food which 
give rise to the eruption, and any others which are not 
readily digested. 

HIVES ANV PRICKLY HEAT. 

The skin disease popularly known as hives is often 
seen in the summer, sometimes recurring in the same 
person several times. The pimples are small, red, and 
pointed, lasting for a week or so. They are usually 
seen on the back of the forearm, neck, and thighs, but 
may appear on the face ; there is a good deal of itching. 
In obstinate cases they may remain for a long time, 
many months, causing severe annoyance. Prickly heat 
is a similar eruption of small pimples excited by expo- 
sure to unusually hot weather. It is quite familiar to 



CAMP ITCH, SOLDIER'S ITCH, OR GROUND ITCH. 1075 

all in this country. Both these diseases are included 
under the name of lichen by physicians. 

In the simpler forms, when there is some feverish- 
ness present, the bowels should be acted upon gently 
by a small dose of magnesia, cream of tartar, Epsom 
salts, a Seidlitz powder, or some saline mineral water. 
The body should be bathed in a bran bath (two pounds 
of bran to about thirty gallons of water), or in one con- 
taining a pound of linseed meal. In prickly heat, 
starch-powder or a weak solution of sugar of lead can 
be applied to the part. 

"When the disease is obstinate, the patient must 
under 0*0 a regular course of constitutional treatment, 
preferably at some mineral spring suited to his condi- 
tion, under the immediate care of a physician; as, 
when once the disease is established, it is by no means 
easy to dislodge it. Arsenic is then one of the most 
important remedies, but none but a physician should 
give it. 

CAMP ITCH, SOLDIER'S ITCH, OR GROUND ITCH. 

These and a variety of other names are given to an 
eruption of dry, small pimples, especially numerous 
on the outside of the forearms, of the legs, and thighs, 
attended with violent itching usually worse at night, 
which is common in the Mississippi Valle} T , and was' 
often seen in the army. It is easily distinguished 
from genuine itch, as this latter is found between the 
fingers, on the hands, and in the flexures of the joints, 
where soldier's itch is never or but rarely seen ; and, 



1076 



DISEASES OE THE SKIN. 



also, genuine itch has often a moist surface studded 
with small crusts, neither of which appearances is 
seen in that we are describing. They yield, also, to 
very different remedies. 

For the soldier's itch, the part after washing should 
be thoroughly rubbed every night for three nights 
with soft soap. After this the eruption should be 
bathed night and morning, and oftener if practicable, 
with the following lotion : — 



Take of— 

Tar, 

Whiskey, each two tablespoonsful. 

Water, half a pint. 
Mix thoroughly. 



Or with the following ointment : — 



Take of— 

Tar, 

Clean lard, each a tablespoonful. 
Mix thoroughly. 



Or with this, which enjoyed an extensive reputation 
in the army: — 



Take of— 

Iodide of potash, half an ounce. 

Clean lard (or glycerine), two ounces. 
Mix, and rub on the parts. 



The usual attention to diet, etc., must also be 
observed. 



MOIST TETTER. 



1077 



III. Diseases with a "Watery Discharge. 



MOIST TETTER, 



"What the public calls "moist tetter," physicians 
know by the name of eczema. It is a common disease, 
with several varieties. They are all marked by the 
appearance on the skin of a great number of small 
blisters, not larger often than the head of a pin, each 
filled with a clear, watery fluid. They run together, 
burst, and pour out their contents, which often dries 
into small crusts, and has the peculiar property of 
stiffening linen. Other crops of little blisters then 
appear and pursue the same course. The skin is 
tender, irritable, inflamed, and moist to the touch ; 
and not unfrequently the general health is impaired, 
the appetite diminished, the tongue furred, and head- 
ache frequent. The eruption may break out in any 
part of the body, and it receives separate names in con- 
sequence. For instance, when on the face of infants, it 
is what is known as "milk crust;" on the head, one of 
the forms of " scald head;" on the face, a kind of 
"barber's tetter;" and on the nipple " chapped nipple" 
The general characteristics of all these are the same, 
the disease commencing with a crop of watery pimples, 
which break and form scabs or crusts. 

The treatment required must be persevered in for 
some time, as the disease is frequently obstinate. In 
the first place, the parts should not be washed with 
soap, as this increases the itching. If there are crusts, 
they are to be softened with sweet oil, and then 



1078 



DISEASES OE THE SKIN. 



washed off with pure, tepid water. After this has 
been carefully done, the part should be gently anointed 
morning and evening with an appropriate ointment. 
Many such ointments are recommended, and often a 
tetter that will not yield to one of them will yield very 
promptly to another. Hence, we shall give several 
recipes, which may be tried in turn until one is found 
which succeeds. 



Take of— 

Tar, 

Soft soap, 

Whiskey, 

Lard, equal parts. 
Rub them well together. 



Strong tar-water is also valuable as a lotion. 
The following is also highly lauded: — 



Or 



Take of— 

Oxide of zinc, a drachm. 

Clean lard, an ounce. 
Rub together, and use while fresh. 



Take of— 








Borax, 


in powder, 






Starch, 


in powder, 


of each 


a teaspoonful. 


Glycerine, 






Clean lard, of each 


a tablespoonful. 


Mix well. 









The eruption is to be completely covered with 
either of these ointments. "When it is desired to 
renew it, the skin should be carefully washed with 
the yolk of an egg beat up in warm water. When 
the disease is on the arms or legs, linen sleeves or 



FEVER BLISTERS. 1079 

cotton drawers should be used. On the head, to 
avoid mattingj the ointment should be applied in the 
direction of the hair. On the face, no covering is 
necessary unless it be some pieces of tissue-paper to 
protect from the air. While these local means are 
used, the bowels must be maintained in regular 
action, the diet must be light, indulgence in stimulants 
avoided, and it may prove necessary to resort to 
constitutional treatment with arsenic. 

FEVER BLISTERS. 

These familiar eruptions appear generally on the 
lips. They are minute blisters filled with water, 
smarting and painful, which in a few days break and 
gradually heal. They also occur on other parts of the 
body, forming one of the varieties of ringworm, and 
are most frequent in children and young persons. 

"When on the lips they are very annoying, especially 
to ladies. Pure cologne water applied at the very 
start may prevent them. Magnesia powder is used 
by some to dust about the lips. Ointment made from 
cucumber is also very grateful in this and other 
irritated states of the skin. Green cucumbers are 
grated, and the pulp slowly heated in clean lard, 
which is then strained. Elder flowers used in the 
same way also yield a useful preparation in similar 
cases. Either of these may be employed in this or 
similar skin diseases. 



1080 DISEASES OE THE SKIN. 



POISON VINE ERUPTION. 



The common poison vine, a kind of swamp sumach, 
and some other plants, cause in certain persons a 
breaking out characterized by watery blisters, such as 
we have described. It appears on the hands and face, 
and may extend to the body. Some suffer from it 
severely, and are almost afraid to go near the woods in 
the summer, lest they should accidentally touch these 
poisonous plants. 

Of the various remedies recommended for it, we 
have found the most success in a weak solution of 
blue vitriol, a piece about the size of a small chestnut 
being dissolved in a quart of water. With this the 
part should be bathed a few times, when the rash 
disappears. A weak solution of sugar of lead some- 
times answers as well. Some have also recommended 
very highly a strong tea of Virginia snakeroot, which 
has been found to heal it very promptly. The only 
way to prevent the disease is to avoid touching the 
plants. 

IY. Diseases characterized by Matter or Pus. 

Sometimes those skin diseases which commence 
with watery blisters, as they are prolonged and grow 
worse, become mattery or covered with pus, like an 
old sore. Milk crust, for instance, and moist tetter 
in the hair or beard, are examples of this. In such, 
the treatment is very much the same as we have 
described under the head of moist tetter. The hair 



ROSY DROP. 1081 

or beard should be kept closely cut. The scabs 
should be removed by softening them with sweet oil, 
clean lard, or unsalted fresh butter; and the skin 
should then be dressed with one of the ointments for 
which we have given the receipt. Poulticing may 
sometimes be necessary in order to remove all the 
crusts which have formed. 

ROSY DROP. 

The hard, small, red pimples, tipped with a black 
point, which so often disfigure the face of the young 
of both sexes shortly after puberty, and the red, 
unsightly swelling on the face of hard drinkers and 
high livers, known as "rosy drop," or vulgarly as 
"rum blossoms," are in reality the same complaint, 
both being inflammations of the small glands which 
furnish the lubricating matter to the skin. They also 
occur in many women who suffer from womb disease, 
and in persons of feeble health and irregular habits. 
The swellings usually contain a drop or so of matter 
or pus, and at times change into small open sores, 
painful and not easy to cure. 

In undertaking a cure, the most important and often 
the most difficult point is to secure from the patient 
the proper attention to hygiene. Excesses in diet and 
drink, late hours, irregular meals, indigestible food, 
and carelessness about irregularities of the bowels, 
must firmly and wholly be renounced. The person 
should be bathed daily in warm water and soap, and 



1082 DISEASES OF THE SKIN. 

at night the points should be painted with the follow- 
ing preparation:- — 




Take of— 

Flowers of sulphur, oue drachm. 

Alcohol, one ounce. 
Mix them. 




Or thi 


s, 






Take of— 

Carbolic acid, five drops. 

Simple cerate, one ounce. 
Mix them. 




If t 


tie eruption depends upon disease of the womb 



or dyspepsia, as is frequently the case, these com- 
plaints must first receive attention. "When the general 
health is feeble, this must be restored by cod-liver oil, 
iron, travel, or some of those other means we have so 
often referred to on previous pages. In young persons, 
washing the face every morning and evening with a 
solution of alum (teaspoonful to a tumbler of water) or 
of borax (same quantities), or pure cologne water, will 
not unfrequently effect a cure. 



Y. Diseases marked by Dry Scales. 

DRY TETTER. 

This is an obstinate affection in which very nu- 
merous small white scales form upon the skin, particu- 
larly the scalp, where it is known as " dandruff," but 



LEPROSY. 1083 

it may occur on any other part of the body, and we 
have seen it covering nearly the whole person. Some 
redness and a good deal of itching usually attend it, 
and in many cases it is difficult of cure. 

Cleanliness, frequent bathing, attention to diet, the 
bowels, and the general health are first to be looked 
after. Then we can turn our attention to the local 
treatment. For dandruff, the best application will be 
found the daily use of the following wash : Take a 
tablespoonful of flowers of sulphur, and stir it in a 
quart of pure water ; let it stand for a day, stirring or 
shaking frequently ; then pour off the clear fluid, and 
wash the head as directed, letting it dry on the scalp. 
No other application will be needed. Some physicians 
recommend cutting the hair short, and washing daily 
with castile soap, followed by a spirituous lotion. 
This may be tried if the former fails. When the 
tetter is on any other part of the body, the same treat- 
ment is to be employed. Soda-baths, as described on 
page 715, and the juice of the poke weed (see page 
732), will be found efficacious in some cases. 

LEPROSY. 

The leprosy spoken of in the Bible still exists in 
the Eastern countries, and is also found in the West 
Indies, but not in the United States. It is marked by 
glossy white scales, which rise on the skin, and then 
loosen and fall off, leaving an ulcer or sore. It is in- 
curable and contagious. 

As it occurs in this country, leprosy is characterized 



1084 



DISEASES OF THE SKIN. 



by red scaly patches of yarious sizes, generally circu- 
lar or rounded in shape, found on any part of the body, 
especially the arms and legs. The margin of the 
patch is always the highest, reddest, and most scaly 
part. It is not held to be contagious. 

The treatment must be vigorous and prolonged, as 
the disease does not yield readily, and, though not 
dangerous, is disfiguring. The use of carbolic acid 
soap has been fcamd advantageous, as has also tar 
ointment, the receipt for which we have already given. 
Arsenic should be taken internally, the diet carefully 
regulated, and fatty articles, as also those highly salted, 
should be eschewed. Baths containing four ounces of 
carbonate of soda should be taken every few days, the 
patient soaking for some twenty minutes or so. In 
addition to this, arsenic may be demanded, which must 
never be used except under the eye of a physician. 



VI. Diseases of Mixed Characters. 



itch. 



True itch is a common contagious disease of the 
skin, caused by the presence of a minute animal — the 
itch mite — which burrows in the skin. The eruption 
usually appears first between the fingers and on the 
back of the hand, next on the arms, legs, and belly, 
hardly ever on the face or scalp. The itching is 
troublesome, being worse at night, and in a warm 
room. The skin shows a breaking out on the surface, 
which may consist only of very small pimple-like ele- 



. * ITCH. 1085 

vations, or little blisters, with scabs and crusts, or 
marks where the nails have scratched the surface, or 
mattery scabs. Looking closely at one of the pimples, 
one may see a little red line, at the end of which may 
be found a slightly elevated point. This is the track 
or burrow of the mite. 

It is important to be able to distinguish the itch 
from other non-contagious skin diseases, some of which 
it resembles. This can be done by remembering that 
it does not appear on the face or head, nor on the back 
of the limbs or body, but between the fingers, in front 
of the arms, on the palm of the hand, and soles of the 
feet; it does not commence with feverishness ; the 
eruption presents a mixed character; the itching 
worse at night; the mark of the burrows; the evi- 
dence that it is catching; an'd the presence of the 
itch mite. 

The treatment for itch is usually successful. After 
thorough bathing and washing of the whole body 
with soap and water, strong sulphur ointment must be 
well rubbed into the parts affected (see page 717). A 
few applications will usually be sufficient. In cases 
of long standing, recovery may, however, be slow, and 
it is not well to continue the sulphur more than five or 
six times. The ointment of iodide of potash mentioned 
under " Camp itch" should be substituted. It may be 
rubbed in night and morning for three days. Oil of 
turpentine or petroleum, as strong as can be borne, is 
also effective in destroying the itch insect. After 
recovery the clothes should be destroyed, and the 
utmost cleanliness observed for months. 



1086 DISEASES OE THE SKIN. 



RINGWORM. 



This is of two varieties, the one appearing chiefly 
on the head, the other on the body. It is characterized 
by its circular form, by a thin powdery crust, or by 
the presence of a margin of small watery blisters. On 
the scalp, it destroys the hair and is one of the causes 
of baldness, usually leaving round patches of skin free 
from hair. One of its forms certainly, and perhaps 
both, are catching, though very seldom transmitted to 
a cleanly person, at least without very close contact. 

The treatment of simple ringworm in its early stages 
is not difficult ; the spot should be washed frequently 
with strong vinegar, or a solution of borax (teaspoonful 
to a wineglass of water, see page 700); painted with 
tincture of iodine, or tincture of cantharides ; or with 
a mixture of a drachm of carbolic acid to an ounce of 
glycerine. Later, the disease becomes more obstinate. 
The spot must sometimes be blistered, the hair plucked 
out, and the surface dressed with tar ointment. 



barber's itch. 



This troublesome disease occurs on the bearded part 
of the face, especially the chin. It is catching, and 
may be transferred from one to another by uncleanly 
barbers in shaving. The hairs appear slightly inflamed 
around their x^oots, and the skin is hardened, scurfy, 
and scabby. The whole chin may become swollen and 
inflamed by it, and the beard may be destroyed. It is 




Tofacep. 1086. 



Treatment of Bleeding. 



DIABETES. 1087 

not so common a disease as many suppose, as other 
eruptions are mistaken for it. This is fortunate, for 
true barber's itch is by no means easy of cure. 

The beard should be kept closely clipped with the 
scissors, but the razor should not be used. Sponging 
twice a day with white castile soap and water will 
be beneficial. The application should be the same as 
we have mentioned under ringworm, namely, tar oint- 
ment, carbolic acid and glycerine, borax solution, etc. 

VII. Diseases oe the Kidneys* and Bladder. 

"We remarked on page 635, that the fluids pass out 
of the body by the skin, kidneys, and lungs, and chiefly 
by the two former. Indeed, the duties they have to 
perform are so closely connected that it is not inap- 
propriate to speak in the present connection of the dis- 
eases to which the kidneys and their associated organs 
are subject. One of the most important we mentioned 
on the page above referred to, namely, 

DIABETES. 

This, we remarked, is characterized by the passage 
of an excessive quantity of water, generally of a very 
pale yellow hue or quite colorless. Sometimes it con- 
tains sugar in large quantities, that substance being 
formed in the body by a diseased process. "When 
this is the case, the complaint is of a much more 
serious character than when no such substance is pre- 
sent. Hence, it is a matter of considerable importance 



1088 DISEASES OF THE KIDNEYS. 

to know how to discover its presence, or to convince 
one's self of its absence. The simplest test is to taste it. 
If sugar be present, a distinct sweetness will be per- 
ceived. A simple chemical test is to warm a little of 
the water after adding a solution of potash. The pre- 
sence of sugar is shown by the liquid assuming a yel- 
low color, which gradually deepens into a dark brown. 
If this color does not appear, it is certain that no sugar 
is present. 

It is difficult to say what causes this disease. No 
doubt it is occasionally brought on by exposure to 
cold and wet, habitual intemperance, injuries, such as 
shocks to the brain and spine, and certain fevers. It 
is well ascertained, however, that it is twice as 
common in men as in women, most frequent in youth 
and middle age, and more liable to attack those 
dwelling in cities than in country' districts. The 
younger the person in whom it begins, the less hope 
is there of recovery ; and in all ?ges the majority of 
those attacked do not survive. 

It begins with a slight loss of flesh and general 
feeling of being unwell ; the water increases in 
quantity, the thirst grows excessive, and often the 
appetite also becomes much more ravenous than 
usual. The skin is dry and harsh, the tongue smooth 
and glassy looking, and the sexual powers and mental 
faculties begin to fail. Diarrhoea and consumption 
often set in, in the course of the disease. 

Medicines have not proved very successful in this 
malady, and much more can be done by a judicious 
diet than by drugs. The most important point is to 



bmght's disease. 1089 

prohibit the use of sugar in the food, and of everything 
which can turn into sugar in the body, such as starch. 
Bread, except bran bread, potatoes, and nearly all 
vegetables and fruits should be excluded. Cabbage, 
however,, onions, spinach, celery, and lettuce are not 
harmful. Fresh milk and liver must not be touched; 
but butter-milk and skim milk may be taken. All 
meats, eggs, and butter are allowed. Tea and coffee 
without sugar do no harm. But spirits, wines, beer, 
and ale are injurious. As much water may be taken 
as the patient wishes, and the diet may be varied and 
liberal, so that the forbidden articles are not included 
in the bill of fare. The greatest attention must be 
given to hygiene, all severe exertion avoided, and the 
skin frequently bathed. 

Diabetes, when sugar is not present in the water, 
does not require any treatment, as it has no serious 
consequences. 

bright's disease. 

This disease received its name from Dr. Bright, the 
physician who first described it correctly. It is an 
affection of the kidney characterized by the presence 
in the urine of the substance called albumen, and by 
dropsy. 

Its approacn is usually slow and insidious, and it 
may be present a long time without being recognized. 
One of its most frequent causes is the continued abuse 
of spirituous liquors; but exposure to cold and wet, 
gout and various other diseases, may lead to it. There 

69 



1090 DISEASES OF THE KIDNEYS. 

is noticed a gradual loss of strength, a pale and puffy 
face, shortness of breath, and frequent desire to pass 
water. Afterwards there are general pains and weak- 
ness, dyspepsia, dropsy, diarrhoea, headache, and finally 
convulsions. The probability in any given case is 
that the result will be fatal, such being the usual 
termination. 

The testes which are employed to detect the presence 
of albumen in the water are very simple. A little 
may be placed in a wineglass and a few drops of 
strong nitric acid added. If albumen is present a 
whitish, cloudy appearance in the fluid will result. 
Or if the water is simply heated for a few seconds 
over a spirit lamp, a similar appearance will be 
presented. 

In the treatment, hygienic management is of the 
first importance. Exposures to cold and wet, or great 
fatigue, must be avoided, and intemperance and all 
other excesses shunned ; flannel should be worn next 
the skin ; moderately warm baths should be taken 
frequently ; the bowels should be kept open and 
regular ; and nourishing food with plenty of milk 
should be provided. Some have said that an exclu- 
sively skim-milk diet will cure the complaint. Iron, 
as in the tonic we have recommended, will be always 
useful, but much medicine is apt to disturb the 
stomach. 

If dropsy makes its appearance, it may be checked 
by the daily use of warm baths, and freely drinking 
cream of tartar lemonade. 



INFLAMMATION OF THE BLADDER. 1091 



GRAVEL 

Consists of small stony masses which form in the 
kidneys or bladder and are passed with the water. 
This is often accompanied with very severe pain, and 
many persons are subject to a "fit of the gravel" every 
few months, when they pass one or several of these 
little pebbles. 

Such persons should endeavor by a proper diet to 
lessen their tendency to this complaint. They should 
not eat much animal food, nor spices or stimulants. 
They should take a tumbler of w T ater two hours before 
dinner and another at bedtime. Frequent baths, 
warm clothing, and moderate exercise w^ill also be 
found of service. As much bicarbonate of soda as 
can be held on a three cent piece should be stirred in 
one of the tumblers of water and taken daily. 

When the attack comes on, free draughts of flaxseed- 
tea or gum Arabic water will do good ; and the same 
amount of bicarbonate of soda as mentioned above 
may be taken every three or four hours. Little, 
\iowever, can be done to relieve the pain when the 
gravel is passing, except to give sufficient doses of 
opium to dull the sense of feeling. Very great relief 
may be obtained by the use of hydrangea as previously 
described. 

INFLAMMATION OF THE BLADDER. 

This may arise from gravel,, from blows or other 
injuries, from strictures, or from exposure to wet and 



1092 DISEASE OF THE BLADDER. 

cold. There are pain and tenderness over the lower 
part of the bowels, a frequent desire to pass water, 
accompanied sometimes with a burning and bearing- 
down sensation during the act. The water itself is 
often clouded, small in quantity, and may even be 
bloody. 

The proper treatment i-s to put a large mustard 
plaster over the bladder, to drink freely of flaxseed-tea 
or gum Arabic water, to loosen the bowels by a 
moderate dose of castor oil, and to take a prolonged 
sitz-bath in warm water. The latter will often be 
found to give great and prompt relief. 





CHAPTEE XIY. 

SURGICAL DISEASES. 



CONTENTS. 



Erysipelas: Causes; Symptoms; And treatment — Boils — Styes — Carbuncles 
— Felons — In-growing toe-nails — Corns — Bunions — Warts — Tumors — The 
difference between malignant and non-malignant tumors — How to tell a 
cancer — Piles — Inflammation of the eyes — Toothache — Earache. 



ERYSIPELAS. 




HIS disease is known under various names. It 
is sometimes called the rose; in some places, 
St Anthony' s fire ; in others, wild-fire. The term ery- 
sipelas, by which it is generally designated, is derived 
from two Greek words which mean to draw near, from 
its tendency to extend itself gradually over the neigh- 
boring parts. 

The principal symptoms of this affection are fever 
and the deep red color of the affected part, which is 
also swollen and painful. The attack is ordinarily 
preceded by chilliness, muscular pains, nausea, and 
vomiting. 

Every portion of the surface of the body is liable 
to this disease. But the skin of the face and head is 
the part much more frequently affected. 

( 1093 ) 



1094 SURGICAL DISEASES. 

The causes of erysipelas are various and numerous. 
Whatever disorders the health may occasion an attack 
of erysipelas. With some persons, certain articles of 
food produce the disease. For instance, there are those 
who cannot eat shell-fish, others who cannot eat straw- 
berries or nuts, without suffering from an erysipelatous 
attack. Suppression of the perspiration by sudden 
exposure to cold often gives rise to the disease. Loss 
of sleep, great excitement or anxiety, and hard study, 
are also capable of inducing it. The bad air in 
crowded hospital wards frequently originates a severe 
form of this malady among the patients, and some- 
times the nurses exposed to it. The disease is in 
some years epidemic in certain communities. 

Erysipelas is, in some of its forms, undoubtedly 
contagious. It is also, as is well known, inoculable; 
that is, the sponge used upon an erysipelatous patient 
may communicate the disease to an ulcer or wound in 
a healthy person. Hence the importance of great care 
in this regard. 

There are two forms of erysipelas: one which fol- 
lows a wound or surgical operation, the other which 
appears from some internal cause in a person who is 
not suffering from any hurt. The tendency to erysip- 
elas which sometimes prevails in a city or hospital, 
renders for the time being the simplest surgical opera- 
tions dangerous, because of the erysipelatous inflam- 
mation which may follow the operation, no matter how 
skilfully performed. During such periods, every in- 
telligent surgeon performs as few operations as is 
possible. 



ERYSIPELAS. 1095 

The treatment should commence with a cathartic, a 
dose of the purgative recommended among the stand- 
ard domestic remedies, or a bottle of the effervescing 
citrate of magnesia, answering an excellent purpose. 
Ten grains of Dover's powder, or a dose of the febri- 
fuge we have recommended on page 777, should be 
taken at night. The whole surface of the body should 
be sponged frequently with warm water, and if the 
patient be strong enough, he should be placed daily in 
a warm bath. 

One of the best remedies for erysipelas is the muri- 
atic tincture of iron. It should be given in doses of 
fifteen or twenty drops, three or four times a day, in a 
wineglassful of sweetened water, drawn into the back 
of the mouth through a straw or glass tube, in order 
to protect the teeth from the action of the acid in the 
iron preparation. 

As an application to the reddened skin, the dilute 
tincture of iodine is excellent. A mixture of equal 
parts of tincture of iodine and alcohol should be ap- 
plied by means of a camel's-hair brush until the sur- 
face becomes of a brown or mahogany color. This 
application to the affected part is to be repeated two 
or three times a day, and should extend over a portion 
of the surrounding sound skin. The only objection 
to this treatment is that it is sometimes, not always, 
attended with pain. For this reason, it is better to 
apply the iodine lightly at first, in order to notice 
whether it increases the suffering. 

The application of a solution of sugar of lead and 
opium is a very soothing and useful one. For the 



1096 



SURGICAL DISEASES, 



manner of preparing and using this solution, see page 
526. 

The diet of the patient should be light but nutri- 
tious. Cool drinks may be freely allowed. The utmost 
cleanliness of the person must be enforced, the linen 
and bedclothes being changed daily. The sick-room 
should be well ventilated. 

As the patient recovers, he should change his room, 
and sleep in another chamber. Gentle exercise in the 
open air is very beneficial during the period of conva- 
lescence. 



BOILS. 

A boil is a small, hard, and painful swelling, caused 
by inflammation of the skin and the tissue immedi- 
ately under the skin. After a certain time the swell- 
ing becomes pointed, and bursts, giving exit to yellow 
matter mixed with blood, and to a hard mass of dead 
tissue which is called the core. 

The pain at first is smarting or burning, but before 
breaking it becomes of a throbbing character. The 
skin is very red and tender. The boil reaches its 
height in from three to eight days. It may attack 
any part of the body, excepting perhaps the sole of the 
foot or the palm of the hand. Some people are rarely 
free for any length of time from these pests. They 
are very apt to appear after a fever, or a severe illness 
of any sort. 

The causes of a boil often cannot be detected. It 
seems to come of its own accord. Usually, however, 



BOILS — STYES. 1097 

it is associated with a bad condition of the general 
health, or is a consequence of a blow or injury received. 
Overwork, excesses of all descriptions, mental anxiety, 
insufficient food, and indeed whatever deteriorates the 
condition of the blood, renders a person liable to the 
invasion of boils. 

The treatment is at once to poultice the part, or 
apply cloths wrung out in warm water. The applica- 
tion of a fig poultice is of service. It is the oldest 
poultice on record. It was applied to Hezekiah in the 
eighth century before Christ. Isaiah said : " Take a 
lump of figs. And they took and laid it on the boil, 
and he recovered." 

The general health should be at once improved by 
tonics, recreation, and good food. There is no remedy 
for those boils which come without any appreciable 
cause like a trip into the country or to the seaside. 

STYES. 

A stye is a small boil of the size of a barleycorn, 
which appears near the edge of the eyelids, particu- 
larly near the inner corner of the eye. 

Scrofulous and weak children are particularly prone 
to suffer from styes. 

The treatment consists in the application of a slip- 
pery-elm poultice to bring the stye to a head, and the 
internal use of cod-liver oil and iron to improve the 
general health. 



1098 SURGICAL DISEASES. 



CARBUNCLES. 



A carbuncle may be defined to be a very large and 
malignant boil. The swelling is very painful, and of 
a dull red color. 

Prof. Gross says: "Elderly persons are most prone 
to carbuncle, and it is generally believed that such as 
are fat and indolent, or addicted to the pleasures of the 
table, are more frequently attacked than the lean and 
active. In my own practice, however, this has not 
been the case. On the contrary, the greatest number 
of instances has occurred in thin subjects, after the 
age of fifty, whose constitution had been broken down 
by long-continued intemperance, impoverished diet, 
deficient clothing, and mental anxiety. In London, 
carbuncle is said to be remarkably common among the 
lower orders, in consequence of the enormous quanti- 
ties of ale and porter which they habitually consume. 
The disease is more frequent in winter than in summer, 
and in men than in women ; occasionally it displays 
an epidemic tendency. Carbuncle is one of the symp- 
toms of plague. The extent of the inflammation varies 
from that of a dollar up to that of a large saucer, 
its average being about that of the palm of a small 
adult hand." 

The most common situation for a carbuncle is the 
nape of the neck, or on the back between the shoul- 
ders. 

The Treatment — Large flaxseed poultices (see p. 519) 
should be applied early, for they afford more relief 
than any other application. The surface may be 



FELONS. 1099 

sprinkled with laudanum. The general health should 
be improved by a generous, easily-digested diet, and 
by the use of tonics. The treatment of the carbuncle 
itself should be intrusted to a surgeon, for the early 
use of the knife greatly relieves suffering, and expe- 
dites recovery. 

FELONS. 

This disease, known also as whitlow, is an inflam- 
mation seated near the nail of the thumb or a finger. ' 

The pain is extremely severe, of a sharp, shooting 
or throbbing character. The part is very tender to 
the touch, and of a dusky red color. Matter forms in 
the course of a few days, and appears as little yellow 
blisters around the side and back of the nail. 

The severity of the pain leads to a fever, restless- 
ness, sleeplessness at night, loss of appetite, back and 
headache, and sometimes even delirium. 

The treatment consists in the application of a poul- 
tice wet with laudanum, and the keeping of the hand 
in a sling, for, if the hand be allowed to hang down, 
the pain and inflammation are aggravated. But the 
chief reliance lies in having a surgeon open the part 
freely and early with the knife. This treatment, al- 
though terrifying to the timid patient, is really not 
painful, and it affords prompt relief to the severity of 
the suffering. Besides, the surrounding structure is 
thus saved from destruction, for if the disease be not 
promptly treated in this manner, there is danger of the 
loss of the end of the finger. 



1100 SURGICAL DISEASES. 



IN-GROWING TOE-NAILS. 

The edges of the nails of the toes, especially that 
of the big toe, often grow into the skin. Great 
suffering is thus caused. 

Surgeons advise that the whole of the offending 
nail, or one-half of it, shall be plucked out by the 
roots with a pair of tweezers. This is a very effectual 
remedy, but one from which the patient is apt to 
shrink. A firm pad placed against the flesh so as to 
push it away from the inverted nail, and confined in 
this position by means of a bandage, is often a very 
effectual procedure. In connection with this bandage 
or alone, the sesquichloride of iron may be applied, 
which destroys both the vitality and sensitiveness of 
the overhanging flesh without occasioning any pain. 

This trouble may be prevented by avoiding the use 
of a narrow, tight shoe, and by cutting the nails in 
such a manner that the thickened and hardened skin 
may not rise above the level of the nail, and thus 
bury the latter. 

CORNS. 

There are few persons who escape altogether trouble 
with corns. In regard to their treatment, we will 
quote the directions we have given in another work: 
So common are corns, that in all our large cities there 
are individuals who devote themselves to their extrac- 
tion, and make a living by it. These gentlemen are 
not always too implicitly to be relied upon. Some, 



CORNS. 1101 

indeed, are skilful and reputable specialists, but the 
majority are ignorant and tricky, thinking of nothing 
but how to " make business," that immortal principle 
which Charles Dickens says is the only stable and 
entirely certain one in English law. We had recently 
in our hands a small book published by one of them, 
in which he urgently dissuades persons from cutting 
their own corns, but always to come to the celebrated 

chiropodist, Dr. , to have it done ($5.00, if you 

please). 

This is charlatanism. All persons can not only 
cut, but cure their corns, if they will take the trouble. 
They can even learn to extract them on the feet of 
others, but not readily on their own. The method is 
simple, the operation painless, and we shall describe 
it. 

The only instruments needed are a pair of small 
steel forceps, and two or three blunt-pointed steel or 
silver instruments, technically called quadrilles. The 
corn is first softened by immersion in warm water, or 
by a drop of oil or glycerine. The foot is then held 
in a good light, and the centre of the corn loosened 
by passing the point of the quadrille gently around 
the circumference of the callous portion. This is 
seized by the forceps, and held to one side while the 
instruments loosen the other side. So the operation 
is continued, very gently and leisurely, until the whole 
callus is loosened and the corn picked out by the for- 
ceps. Under ordinary circumstances not the least 
pain need be given and not a drop of blood shed. 
This is the art and the mystery of corn-doctoring. 



1102 



SURGICAL DISEASES. 



It requires some skill, some command over the 
fingers and the nerves ; it cannot be performed on 
one's self. This is disappointing. But we have not 
yet divulged all the " tricks of the trade." Here are 
some methods of curing one's own proper and pecu- 
liar corns without assistance from any one. 

Take several small pieces of ordinary sticking-plas- 
ter. Cut in them holes the size of the corn. Apply 
one over the other so as to surround the corn, but 
leave it exposed. Then in the opening drop a satu- 
rated solution of caustic soda, and cover with a thin 
piece of plaster. Renew this every other day for 
eight or ten days, and the corn will be gone. 

Or cut the corn carefully with a knife not too sharp, 
taking care that it is not cut to the quick or to blood. 
Then touch it lightly with nitrate of silver in stick. 
In two or three days a dark, callous crust will cover 
the surface. Remove this with the knife, and apply a 
second time the silver nitrate. Do this for a fortnight, 
and if it is judiciously and regularly done, and the 
part protected from pressure, it will cure any corn. 

Very painful corns can be helped by being covered 
with the following plaster, though we have little faith 
in its curative powers: — 



Take of— 

Resin plaster, one ounce. 
Melt and stir in. 

Muriate of ammonia, two drachms. 

Powdered opium, one drachm. 



The strong tincture of iodine applied daily is often 
an efficient remedy, and another is to rub them morn- 



BTJXIOXS. 



1103 



ing and night with a piece of pumice-stone. If well 
softened beforehand, this latter method, though tedi- 
ous, is satisfactory and painless. It is particularly 
suited to soft corns between the toes. 

A word concerning the cutting of corns. There is 
a right and a wrong way to do even this. Bear in 
mind that the part of the growth which is thick and 
painful is not near the edges, but in the centre. There- 
fore, they should be pared into a concave or funnel 
shape; not flat across, but deeper in the middle than 
at the circumference. 



BTTNTONS. 

A bunion may be described as a very large corn 
situated on the outer side of the joint of the great toe. 
The wearing of short, high-heeled, and narrow-soled 
boots, which throw the whole weight of the body on 
the front part of the foot, is the chief cause of bun- 
ions. 

On the first indications of the coming of a bunion, 
a small, flat, and hollow ring of India-rubber should 
be procured, and worn so as to ward off pressure from 
the shoe. The pain, when the bunion is fairly formed, 
may be relieved by poulticing and painting with the 
tincture of iodine, or touching with the nitrate of 
silver. If the bunion should become actively inflamed, 
it is better to call in the aid of a surgeon, for the use- 
fulness of the joint may be affected if the trouble be 
neglected. 



1104 SURGICAL DISEASES. 



WARTS. 



These annoying excrescences on the hands and face 
often appear upon several members of the same family, 
and seem, in some instances, to be hereditary. Their 
cause is not known. 

The Treatment — The application of a mixture of 
equal parts of chromic acid and water, by means of a 
glass brush, is an effectual and not a painful remedy. 
Under its influence the part turns black, and in the 
course of six or eight days the wart drops off, leaving 
a healthy sore spot, which soon heals. The use of the 
tincture of iodine, or the touching of the wart with 
nitrate of silver, will also cause it to disappear. So 
also will a current of electricity passed through the 
wart daily. 

TUMORS. 

Surgeons divide all tumors into malignant and 
benign. A malignant tumor is one which is danger- 
ous, which may destroy the part or the life of the 
patient. A benign or non-malignant tumor is one 
which is not attended with any danger; it is simply 
an inconvenience by its location, size, or weight. 

It is not our design here to enter at length into a 
description of the different kinds of tumors, for there 
are very many of them. It would be impossible for 
us to give to our non-medical reader such information 
as would enable him to distinguish one from the other, 
and institute the proper treatment. "We would advise 
him to seek for himself or a member of his family, 



HOW TO TELL A CANCER. 1105 

when suffering from a tumor of any sort, intelligent 
medical advice early in the disease. 

We can, however, we think, give him some infor- 
mation which in many cases will enable him to tell 
positively that the tumor is not a cancer. This infor- 
mation we believe useful, as there are a multitude 
of charlatans, "cancer doctors" — designing men who 
trade upon the fears of the community. They call 
every case of a tumor, which comes to them, a cancer, 
and make money at the expense of the mental tran- 
quillity and the bodily sufferings of their victims, 
induced by their alarming statements and their caustic 
applications. 

HOW TO TELL A CANCER. 

The tumor is very hard; it feels like marble under 
the skin. It is not a disease of early or middle life ; 
it rarely appears before the age of forty-five. It 
grows slowly, and never becomes very large — at the 
outside, not beyond the size of a double fist. The 
pain is peculiar ; it is of a sharp, darting character, 
like the passage of a needle through the part. The 
disease rarely lasts longer than two years. 

A tumor which falsifies this description is not a 
cancer, whatever else it may be. The travelling em- 
piric who tries to convince the patient that it is so, 
is guilty of deceit, and worthy of no confidence. 



70 



1106 SURGICAL DISEASES. 



PILES. 



Piles, or haemorrhoids, as they are called by physi- 
cians, are of two varieties — the external and internal; 
that is, those within, and those ontside of the bowel. 

External piles are readily and safely treated by the 
surgeon. Their removal is attended with little suffer- 
ing and no danger. If the patient be not willing to 
submit to an operation, there are various simple mea- 
sures which will afford relief to the pain. Sponging 
the parts with cold water night and morning, or with 
water to which alum or sugar of lead has been added, 
is useful. Much benefit is also derived from the em- 
ployment of the ointment of nutgalls, made with the 
addition of twenty grains of powdered opium to the 
ounce of the ointment. 

Internal piles are more serious, and difficult of cure. 
The loss of blood which they sometimes occasion is 
not unfrequently very exhaustive to the patient. The 
surgeon can effect a radical cure by their removal, but 
the operation should only be performed by skilful 
hands, as it is not unattended with danger. 

An excellent palliative in cases of internal piles is 
an injection of a pint of cold water every morning. 
Under the use of this simple remedy, with a few 
grains of rhubarb daily, long-standing cases have not 
unfrequently been found to yield completely. An 
injection of alum and water, of the strength of one or 
two teaspoonsful of alum to the pint of water, may 
be used with advantage in bleeding and painful piles. 
Sulphate of iron, dissolved in water in the proportion 



INFLAMMATION OF THE EYE. 1107 

of two grains to the ounce of water, is also of great 
service, employed once a day as an injection, to check 
the bleeding. 

When there is much irritation and pain, great 
relief is often obtained from the hip-bath, from sitting 
over the steam of hot water for fifteen or twenty 
minutes, and immediately applying a warm bread-and- 
milk poultice; these measures should be repeated five 
or six times a day. 

INFLAMMATION OF THE EYES. 

In consequence of exposure to cold, the irritation 
of dust, too bright a light, or too constant use, the 
lining membrane covering the eye and lining the lids 
sometimes becomes red and inflamed. The eye feels 
as if there were some fine sand in it. There is a 
watery discharge, and the patient, perhaps, complains 
that in the morning the lids are glued together by a 
dried secretion. 

The treatment of this condition is a simple one. 
The eyes should be bathed every two or three hours, 
or oftener if the attack is a severe one, with a lotion of 
alum (four grains to the ounce of water), or of sulphate 
of zinc and alum mixed (three grains of alum and one 
grain of sulphate of zinc to the ounce of water), 
taking care that with each application a little is 
allowed to flow into the eyes. In the intervals 
between the times for using the lotion the eyes may 
be bathed with cold water, to keep them free from the 
discharge. To prevent the gumming together of the 



1108 



SURGICAL DISEASES. 



eyelids during sleep, a little cold cream, or of lard 
free from salt, may be smeared along their borders 
every night. 



TOOTHACHE. 

For this troublesome affection relief should be 
sought at the hands of the dentist. A tooth that 
aches is more or less decayed, and the progress of 
this decay should be arrested, as soon as possible, by 
plugging. 

To relieve at the time the pain of the aching tooth, 
there are many domestic remedies employed, some of 
which are hurtful. The introduction of a piece of 
cotton soaked in chloroform into the hollow of the 
tooth will often afford instant relief. The following 
mixture is very highly recommended : — 



Take of— 




Tannin, twenty grains. 




Gum mastic, ten grains. 




Ether, one-half fluidounce. 


Mix. 


Wet a piece of cotton with this 


, and introduce it into 


the aching tooth. 





Toothache is sometimes speedily cured by rubbing 
the gums with a few drops of tincture of aconite, or 
moistening a piece of cotton with it and putting it 
into the tooth. If the aconite afford any relief, it 
will do so at once, so that if relief be not speedily 
obtained it is useless to persevere in its use. 

The use of liquor gutta-percha (solution of gutta- 
percha in chloroform) on cotton is often of service. 



EARACHE. 1109 

A mixture of equal parts of tincture of aconite, 
compound tincture of benzoin, and chloroform, applied 
by means of a pledget of cotton, is an excellent 
remedy. 

EARACHE. 

Relief is often afforded by warming some laudanum 
(by standing the bottle in warm water), filling the 
affected ear with it, and retaining it by means of a 
plug of cotton. There is no danger in so doing, for 
the laudanum, employed in this way, cannot do any 
hurt. When there is pain in the side of the face, or 
in the ear, in consequence of a decayed tooth, the 
same procedure will often afford relief and secure a 
good night's sleep. 

A mixture of equal parts of laudanum and sweet 
oil, introduced into the ear by means of a piece of 
cotton soaked in it, will also often afford speedy relief. 

The cause of the trouble in obstinate earache should 
be diligently sought for, in order that it may be 
removed. A decayed tooth will sometimes be found 
to be the unsuspected influence at work. In other 
instances the pain is due to neuralgia, which should 
be treated in the manner mentioned in our article on 
that disease. 



m&m 




"■mss 




CHAPTER XV. 

ACCIDENTS AND INJURIES. 

CONTENTS. 

Sunstroke : its causes, treatment, and prevention — Injuries from cold : frost- 
bites ; chilblains — Treatment of the apparently drowned : first measures 
for restoration ; to restore the breathing ; after breathing has been restored ; 
appearances accompanying death ; cautions — Poisons and their antidotes : 
prussic acid ; laurel-water ; muriatic acid ; nitric acid ; sulphuric acid ; 
oxalic acid ; ammonia ; mussels, crabs and crawfish ; bites of serpents, 
rattlesnakes, copperheads, vipers ; tartar emetic ; arsenic ; belladonna ; 
thorn-apple ; tobacco ; aconite ; copper ; poisonous gases ; lead ; corrosive 
sublimate ; mushrooms ; nux vomica ; strychnia ; laudanum ; henbane ; 
savine ; nitrate of silver ; tin ; sulphate of zinc — Burns and scalds — Railroad 
and other injuries, and how to stop bleeding — Bleeding of the nose, at the 
lungs — Foreign bodies in the ear, the eye, the nose, the throat — Bruises — 
Sprain s— Fainting. 



Sunstroke. 




HIS is an affection of the nervous system in- 
duced by exposure to heat. It is associated 
with dizziness and sometimes with headache, or the 
gradual coming on of listlessness and torpidity, with 
a desire to lie down. These symptoms may culminate 
in more or less sudden and complete insensibility, 
without the power of sense or motion, the breathing 
being rapid and more and more noisy as death ap- 

( mo ) 



SUNSTROKE — TREATMENT. 1111 

proaches. Jerking and twitching of the limbs usher 
in a complete state of unconsciousness, in which the 
patient gradually dies. The approach of death is 
shown by the failure of the heart's action, the flutter- 
ing of the pulse, the irregularity of the breathing. 
The patient may die within from five minutes to a few 
hours after the attack. In cases which recover, there 
are very apt to be troublesome consequences, such as 
forms of palsy more or less complete, depression of 
spirits, loss of memory, and perhaps some form of in- 
sanity. Often years elapse before the patient fully 
recovers his mental and physical health. 

The cause of sunstroke is not merely exposure to 
the direct rays of the sun as many suppose. A heated 
atmosphere in the shade or in a room may cause an 
attack in one predisposed to it. Whatever lowers the 
tone of the nervous system lays a person on exposure 
open to this disease, hence excessive fatigue, bad 
ventilation, and particularly intemperate habits, lead 
to an attack in warm weather. The exposure of the 
back of the neck to the direct influence of the slanting 
rays of the sun is especially dangerous. 

THE TREATMENT 

Of sunstroke consists in removing the patient at once 
to the nearest cool and shady place ; laying him down 
with his head a little raised ; dashing cold water over 
the head, neck, and chest, after removing the clothing, 
and pouring a stream of cold water over the head and 
chest from a bucket held some feet above the patient. 



1112 ACCIDENTS AND INJURIES. 

Mustard poultices may be applied to the calves of the 
legs and soles of the feet. "When the patient can 
swallow, he should partake freely of good tea, which 
is an excellent remedy, stimulating the nervous sys- 
tem and acting upon the skin. 

Rubbing the whole body with pieces of ice as large 
as can be conveniently handled, and keeping pieces in 
the armpits, until there is returning consciousness, 
which may not be for several hours, and then giving 
iced wine and water, is a method of treatment recom- 
mended by experienced physicians in this disease. 

THE PREVENTION OF SUNSTROKE. 

The heat of the sun is particularly apt to affect 
soldiers on the march. Therefore, when a long march 
is to be undertaken during hot weather, the weak and 
sickly should be left behind. The dress should be 
suitable for the early morning hours before sunrise, .as 
well as for the scorching heat which follows. A flannel 
shirt is a safeguard against sudden chills; a flannel 
belt is an advantage, except in the hottest weather. 
The shirt-collar ought to be open. A light knapsack 
should be allowed, which does not require the use of 
cross-belts over the chest. The troops should march 
"easy" and loosely clad; at a pace not exceeding 
three and a half miles an hour ; with halts when the 
men are exhausted ; and with a longer halt half-way, 
so that each man may have a biscuit and a cup of 
coffee. There should be an ample supply of water, 
but no spirits, allowed. 



INJURIES PROM COLD. 1113 

The Havelock, a linen cape attached to the hat, and 
falling over the neck so as to protect the upper part 
of the spinal column, is an excellent preventive against 
sunstroke, and should be worn by all those whose 
occupations force them to be exposed to the direct 
rays of the sun in hot weather. A wetted towel or 
sponge placed over the head under the cap is also 
useful. 

Injuries from Cold. 

Dr. Hope gives the following advice in regard to the 
treatment of people being frozen and of frost-bites: — 

"Whether the whole body or only a part is affected, 
the principle of the treatment is the same. 

Avoid a sudden change. If a person be found quite 
benumbed with cold, if you take him direct to a fire 
you may perhaps destroy life ; a barn, a shed, or a 
room, which feels very cold to you, is warm enough at 
first. Remove the clothes if wet, and rub the body 
dry; put him into blankets, and give a little warm 
wine and water, or weak spirit and water, or tea ; after 
a while remove him to a warmer room, but still not 
near a fire, and so gradually increase the warmth. 

If you should ever be so situated in intensely cold 
weather as not to be able to reach a place of shelter, 
and find your strength failing, look out for a snow- 
drift on the side of a hill away from the winds ; or if 
on a plain, try to find a hollow filled up with snow ; 
scrape a hole large enough for your body and creep 
into it, then you are comparatively safe: the snow 
will shelter you from the wind and keep you warm. 



1114 ACCIDENTS AND INJURIES. 

Human beings and sheep have lain for days in this 
way, and been saved. But never forget the first 
warning of danger. If you feel a desire to sleep, and 
give way to it in the open country, it will be the sleep 
of death ; you must keep in motion, however painful, 
or perish. 

But there is another effect of cold, which is gene- 
rally caused by standing or walking against a very 
cold wind, which is called being nipped. I have seen 
a person suddenly seized with great pain in the bowels, 
drawn together with cramp, the hands so swollen as to 
require the gloves to be cut off, and with intense head- 
ache. The same treatment answers: gradual warmth, 
very small quantities of warm stimulants, and, after a 
while, hot flannel to the painful parts. 

EROST-BITES 

Attack the extremities and projecting parts of the 
body, hands, feet, nose, ears. They are frequently so 
rapid and free from pain, that a person is not aware of 
anything being w^rong. In Canada, when meeting a 
friend in the street, the caution is often both given and 
taken, " Mind your nose, sir, it looks whitish." The 
blood, you know, when warm, is fluid, but when it is 
cold, forms a solid clot; and you also know that when 
water or other liquid freezes, it expands, and so 
breaks water bottles and jugs, and it also becomes 
lighter. Now, precisely the same thing takes place 
in frost-bites ; the blood in the part gets cold and runs 
slowly, then stops, all the little bloodvessels are 



FROST-BITES — TREATMENT. 1115 

choked and swollen, you apply heat and burst them, 
causing dreadful suffering and troublesome wounds; 
or, if you do nothing, the circulation is quite stopped, 
and the part dies or mortifies. 



TREATMENT. 

Keep the person away from all heat ; if you can, get 
clean snow and rub the parts constantly with it; or, if 
you cannot find snow, get the coldest water. Let the 
patient himself rub if possible, for the exertion will 
keep him sufficiently warm. You must continue this 
rubbing for hours in severe cases, till you get the 
parts quite soft, and something near the natural color. 
You must not allow any complaints or feeling of com- 
passion to stop your rubbing, or to cause you to bring 
him into a warm room. Put on extra clothing, or let 
him have a run for a minute, but do not come near a 
fire. After you have done this, anoint well with sweet 
oil or lard, or lime-water and oil, and wrap up well 
with flannel. 

If you should have any sores, dress them the same 
as burns. The following case on board a steamer 
happily caused more amusement than suffering. The 
men were busy in the very dirty employment of 
removing ashes. One of the engineers, being off 
duty, had dressed himself in his shore clothes, ready 
for a walk. After standing some time talking, one of 
the men noticed the white patch on his cheek, and 
instantly gathering a handful of snow, commenced 
rubbing vigorously. In his eagerness to benefit his 



1116 ACCIDENTS AND INJURIES. 

friend, he had forgotten the state of his hands, till the 
snow began to melt, which gave an extraordinary 
mottled black and white look to the engineer's face, 
and little ink-like streams trickled down his best 
clothes. 



CHILBLAINS 

Are in truth the same in every way as frost-bites, but 
in a milder form. They are more troublesome than 
dangerous, though in persons of weak circulation, 
or if neglected, they cause sores which last through 
the winter. 

Prevention is better than cure. The only way to 
prevent them is to wear warm clothing on the hands 
and feet, keep up the circulation by exercise, and, 
above all things, not to bring them suddenly from cold 
to great heat. This is the whole secret of prevention. 
"When they are formed, but not broken, rub- well two 
or three times a day with equal parts of turpentine 
and laudanum, or equal parts of camphorated spirit 
and soap liniment, or sweet oil and spirits of turpen- 
tine, or with an ointment made- of a teaspoonful of dry 
mustard and an ounce of lard. Any of these are 
good ; but if the skin be broken, do not use them, but 
dress them just like a sore after a burn, or with the 
old-fashioned but excellent application of chalk and 
tallow; but it is not safe to use the grease of candles, 
as chemicals are so much used in making them, but 
take a little mutton tallow, melt it, and while warm 
mix it with whiting till it is of a proper thickness for 



HOW TO RESTORE DROWNED PERSONS. 1117 

use. Either of these will give almost immediate 
relief. 

Treatment of the Apparently Drowned. 

The following instructions for the revival of persons 
apparently drowned are, in the main, those compiled 
by the British Royal National Life Boat Institution. 
These rules apply in all cases and in every country. 



FIRST MEANS OF RESTORATION. 

Send immediately for medical assistance, blankets, 
and dry clothing, but proceed to treat the patient 
instantly on the spot, in the open air, with the face 
downward, whether on shore or afloat, exposing the 
face, neck, and chest to the wind, except in severe 
weather, and removing all tight clothing from the 
neck and chest, especially the braces. The points to 
be aimed at are — first, and immediately, the restoration 
of breathing; and secondly, after breathing is restored, 
the promotion of warmth and circulation. The efforts 
to restore breathing must be commenced immediately 
and energetically, and persevered in for one or two 
hours, or until a medical man has pronounced that life 
is extinct. Efforts to promote warmth and circula- 
tion, beyond removing the wet clothes and drying the 
skin, must not be made until the first appearance of 
natural breathing. For if circulation of the blood be 
induced before breathing has recommenced, the resto- 
ration to life will be endangered. 



1118 ACCIDENTS AND INJURIES. 



TO RESTORE BREATHING. 



Place the patient on the floor or ground, with the 
face downward, and one of the arms under the fore- 
head, in which position all fluids will more readily 
escape by the mouth, and the tongue itself will fall 
forward, leaving the entrance into the windpipe free. 
Assist this operation by wiping and cleansing the 
mouth. If satisfactory breathing commences, use the 
treatment prescribed below to promote warmth. 

If there be only slight breathing, or no breathing, 
or if the breathing fail, then, to excite breathing, turn 
the patient well and instantly on the side, supporting 
the head, and excite the nostrils with snuff, hartshorn, 
and smelling salts, or tickle the throat with a feather, 
if they are at hand. Rub the chest and face warm, 
and dash cold water, or cold and hot water alternately, 
on them. 

If there be no success, lose not a moment, but 
instantly — to imitate breathing — replace the patient 
on the face, raising and supporting the chest well on a 
folded coat or other article of dress. Turn the body 
very gently on the side and a little beyond, and then 
briskly on the face back again, repeating these 
measures cautiously, efficiently, and perseveringly 
about fifteen times in the minute, or once every four 
or five seconds, occasionally varying the side. On 
each occasion that the body is replaced on the face, 
make uniform but efficient pressure, w T ith brisk move- 
ment on the back, between and below the shoulder- 



HOW TO RESTORE BREATHING. 1119 

blade or bones on each side, removing the pressure 
immediately before turning the body on the side. 

During the whole operation, let one person attend 
solely to the movements of the head and the arm 
placed under it. "While the above preparations are 
being proceeded with, dry the hands and feet, and as 
soon as dry clothing or blankets can be procured, strip 
the body and cover or gradually reclothe it, but taking 
care not to interfere with the efforts to restore breathing. 
Should these efforts not prove successful in the course 
of from two to five minutes, proceed to imitate breath- 
ing as follows : Place the patient on the back on a flat 
surface, inclined a little upward from the feet ; raise 
and support the head and shoulders on a small firm 
cushion or folded article of dress, placed under the 
shoulder-blades. Draw forward the patient's tongue, 
and keep it projecting beyond the lips; an elastic 
band over the tongue and under the chin will answer 
this purpose, or a piece of string or tape may be tied 
round them, or by raising the lower jaw the teeth may 
be made to retain the tongue in that position. 
Remove all tight clothing from about the neck and 
chest, especially the braces. 

In order to imitate the movement of breathing, take 
your place at the patient's head, grasp the arms just 
above the elbows, and draw the arms gently and 
steadily upward above the head, and keep them 
stretched upwards for two seconds. By this means 
air is drawn into the lungs. Then turn down the 
patient's arms, and press them gently and firmly for 
two seconds against the sides of the chest. By this 



1120 



ACCIDENTS AND INJURIES. 



means air is pressed out of the lungs. Repeat the 
measures alternately, deliberately, and perse veringly 
about fifteen times in a minute, until a spontaneous 
effort to respire is perceived, immediately upon which 
cease to imitate the movements of breathing, and 
proceed to induce circulation and warmth. 

AFTER BREATHING HAS BEEN RESTORED. 

Commence rubbing the limbs upward, with firm, 
grasping pressure and energy, using handkerchiefs, 
flannels, etc. ; by this measure the blood is propelled 
along the veins toward the heart. The friction must 
be continued under the blanket or over the dry cloth- 
ing. Promote the warmth of the body by the appli- 
cation of hot flannels, bottles or bladders of hot water, 
heated bricks, etc., to the pit of the stomach, the arm- 
pits, between the thighs, and to the soles of the feet. 
If the patient has been carried to a house after respi- 
ration has been restored, be careful to let the air play 
freely about the room. On the restoration of life, a 
teaspoonful of warm water should be given; and then, 
if the power of swallowing has returned, small quan- 
tities of wine, warm brandy and water, or coffee should 
be administered. The patient should be kept in bed, 
and a disposition to sleep encouraged. 



APPEARANCES ACCOMPANYING DEATH. 

Breathing and the heart's action cease entirely; the 
eyelids are generally half closed, the pupils dilated, 



APPEARANCES AC COMP ANTING}- DEATH. 1121 

the jaws clenched, the fingers semi-contracted, the 
tongue approaches to the under edges of the lips, and 
these, as well as the nostrils, are covered with a frothy 
mucus. Coldness and pallor of surface increase. 



CAUTIONS. 

Prevent unnecessary crowding of persons around the 
body, especially if in an apartment or confined space. 

Avoid rough usage, and do not allow the body to 
remain on the back unless the tongue is secured. 

Under no circumstances hold the body up by the 
feet, or roll it with a barrel. 

On no account place the body in a warm bath, un- 
less under medical direction, and even then it should 
only be employed as a momentary excitant. Avoid 
the immediate removal of the patient, as it involves a 
dangerous loss of time. Also the use of the bellows 
or any forcing instrument. 



Poisons and their Antidotes. 

The appearance suddenly in a healthy person, soon 
after some substance has been swallowed, of severe 
symptoms of illness, may justly excite the suspicion 
that he has been poisoned. 

The first thing to be done under such circumstances 
is as soon as possible to get rid of the poison by 
means of an emetic. Free vomiting may readily be 
induced by mixing in a tumbler of warm water a tea- 

71 



1122 



ACCIDENTS AND INJURIES. 



spoonful each of salt and mustard, and getting the 
patient to swallow it all, following it up, if necessary, 
with another tumblerful. 

"When the symptoms resemble those of poisoning by 
copper or tin, which will be found described below, 
the kitchen utensils ought to be carefully examined. 
Much anxiety may be saved by a resort to this simple 
precaution. 



POISONS. 



SYMPTOMS. 



ANTIDOTES. 



Acid, Prussic. 

Laurel-water. 

Cyanide of Po- 
tassium. 



In large doses imme- 
diate death ; in smaller, 

Extreme nervous 
prostration and paraly- 
sis gradually terminat- 
ing in death. 

Odor of the poison is 
very perceptible on 
breath, and from all se- 
cretions. 



Chloroform exhibited in tea- 
spoonful doses diluted, and re- 
peated every few minutes until 
symptoms subside and patient 
sleeps. 

Inhalation of steam containing 
the solution of ammonia, cold 
douche, friction to the spine. 
Artificial respiration (described 
under the head of drowning). 
Chlorine-water in strength two 
drachms to one ounce. 



Acid, Muriatic. 
" Nitric. 
" Sulphuric. 



In large doses imme- 
diate death; a peculiar 
shrivelled appearance 
of lining membrane of 
mouth and throat; in- 
tense burning in throat, 
gullet, and stomach. 



Repeated and copious drafts of 
water to dilute the acid. 

Chalk or calcined magnesia in 
milk:. 

Strong solution of soap. So- 
lution of soda is by many pre- 
ferred. 

It should be recollected that 
the mineral acids are very rapid 
in their caustic action upon the 
animal tissues, and that even if 
antidotes are instantly and suc- 
cessfully employed, a certain 
mischief is always inflicted; 
therefore in after-treatment avoid 
distending the stomach with li- 
quids. 



POISONS AND THEIR ANTIDOTES. 1123 


POISONS. 


SYMPTOMS. 


ANTIDOTES. 


Acid, Oxalic. 


Intense burning pain 


From the rapidity and certain- 




of mouth, and throat, 


ty with which it destroys life, no 




and stomach, vomiting 


time is to be lost in attempting 




blood which is highly- 


its expulsion by emetics. (Mus- 




acid, violent purging, 


tard and salt in water.) 




collapse, stupor, death. 


Employ immediately chalk or 




Note. Frequently- 


carbonate of magnesia in sub- 




taken in mistake for 


stance or solution. Put two ta- 




Epsom salts, to which 


blespoonsful of the magnesia in 




in shops it often bears a 


a pint of water, and give a wine- 




strong resemblance. 


glassful every two or three min- 
utes. While this is getting ready, 
knock, if necessary, a piece of 
plaster off the wall, pound it well, 
and give it in milk or water ; or, 
give a tablespoonful of soft soap, 
or bits of common soap in water. 


Alkalies. Am- 


Excoriation of mouth 


Vinegar, lemon-juice, and ci- 


monia. 


and throat, burning in 


tric acid, with large quantities of 




throat, chest, stomach, 


water. 


Caustic Potash. 


and intestines ; colic, 


Give freely of sweet oil. 




purging, and vomiting 


Mucilaginous and demulcent 




of bloody matter. 


drinks. 


Animal. 


Those of cholera, fol- 


Evacuate as rapidly as possible 




lowed by paralysis of 


the contents of the stomach and 


Conger. 


lower extremities. 


bowels. 




Nausea, immoderate 


Sour drinks ; chloroform inter- 


Mussels. 


thirst, irritating eruption 


nally in teaspoonful doses. 




of skin, low pulse, cold- 


Pure Cayenne pepper is thought 


Crabs. 


ness of extremities, 
rarely death. 


to be a specific. 


Crawfish. 






Animal. 


Great pain in the bit- 


Bibron's antidote, a spoonful 




ten part, increased on 


every hour. 


Bites of Ser- 


pressure, swelling at 


Tie a string tightly above the 


pents. 


first pale, then red, 


wounded part, rub on well a piece 




livid, gangrenous, and 


of lunar caustic, or burn with a 


Rattlesnakes. 


excessively hard. 


red-hot iron. Apply cupping- 




Vomiting, convul- 


glass or mouth. Brandy and 


Copperheads. 


sions, small pulse, in- 


whiskey in large quantities, with 




creased respiration, cold 


other active stimulants. 


Vipers. 


sweats, delirium, death. 


Bisulphite of soda in large 
doses has been highly recom- 
mended. 


, 



1124 



ACCIDENTS AND INJURIES. 



POISONS. 



SYMPTOMS. 



ANTIDOTES. 



Antimony, Chlo- 
ride of. 



Difficulty in swallow- 
ing, vomiting, pain in 
throat, dilated pupils, 
stupor, violent griping, 
collapse, stupor, death. 



As an emetic, copious emol- 
lient and demulcent drinks, con- 
taining excess of sugar, followed 
by antidotes for other prepara- 
tions of antimony. See below. 



Antimony, Salts 
of. 

Kermes Mine- 
ral. 

Sulphuret. 

Tartar Emetic. 



Nausea, violent vom- 
iting and purging, colic, 
burning pain in pit of 
stomach, cramps of 
lower extremities, ina- 
bility to swallow, se- 
vere lung symptoms 
distress the patient, de- 
lirium, convulsions. 



Large quantities of infusion or 
tincture of cinchona, or, if more 
readily procured, the powdered 
bark. 

The infusion or powder of galls. 

Giye plenty of strong tea. 
Support the strength of the pa- 
tient. 



Arsenic and its 
preparations. 



May appear in a few 
minutes or not for seve- 
ral hours. 

Faintness, nausea, in- 
tense burning pain in 
stomach andthroat, 
vomiting of a turbid 
brown fluid, intense 
thirst, purging, cold 
sweats, convulsions, 
death. 



Hydrated peroxide of iron, re- 
cently prepared and in large 
doses, procured by the addition 
of an excess of water of ammo- 
nia to muriated tincture of iron, 
which yields the peroxide as a 
dense precipitate, and should be 
given in tablespoonful doses every 
five minutes until the symptoms 
are relieved. 

While the above is in prepara- 
tion, emetics should be freely ex- 
hibited, and the stomach emptied 
and carefully washed with the 
pump. Raw eggs beaten up in 
milk are useful. A large dose of 
castor oil may be given to carry 
off the poison in the bowels. 
Lime-water, and flour and water, 
are beneficial. 



Belladonna. 



Thorn-Apple. 



Tobacco. 



Dryness of mouth and 
throat, great thirst, diffi- 
cult swallowing, nau- 
sea, loss of vision, ver- 
tigo, delirium, death. 

Vertigo, headache, 
perversion of vision, 
slight delirium, sense of 
suffocation, disposition 
to sleep, bowels relax- 
ed, and all secretions 
augmented. 

Yertigo, stupor, faint- 
ing, nausea, vomiting, 
sudden nervous debility, 
cold sweat, tremors, and 
at times fatal prostra- 
tion. 



The most prompt emetics and 
use of the stomach-pump, large 
drafts of tincture or infusion of 
cinchona or galls. 

Tannin in large doses. Elec- 
tro-magnetism. Opium has been 
used with much success. Ac- 
tive stimulation, Cayenne pepper, 
ammonia, brandy, cold douche, 
and chloroform. 



POISOSTS AND THEIR ANTIDOTES. 



1125 



POISONS. 



SYMPTOMS. 



ANTIDOTES. 



Aconite. 



Burning and numb- 
ness of the mouth, 
throat, and stomach, 
violent yomiting, but 
neither coma nor con- 
vulsions. 



As above. 

Immediate and free administra- 
tion of animal charcoal mixed 
with water, and followed by brisk 
emetic. 



Copper, Salts of. 
Verdigris. 



Dryness of mouth and 
throat, nausea, ptyalism, 
coppery eructations, 
vomiting, dreadful colic, 
excessive thirst, etc. 



Large doses of simple syrups 
as warm as can be swallowed un- 
til the stomach rejects the amount 
it contains. 

The whites of eggs, and large 
quantities of milk, afterwards 
strong tea, but do not give vine- 
gar. 

Hydrated peroxide of iron. 



Gas, 



Carbonic 
Acid. 

44 Chlorine. 

" Cyanogen. 

" Hydro sul- 
phuric Acid, 
and other poi r 
sonous gases. 



Great drowsiness, 
difficult respiration, fea- 
tures swollen, face blue 
as in strangulation. 



Artificial breathing, as de- 
scribed in speaking of the resus- 
citation of the drowned, cold 
douche, frictions with stimulating 
substances to the surface of the 
body. 

Inhalations of steam contain- 
ing preparations of ammonia. 
Cupping from nape of neck. 

Internal use of chloroform. 



Henbane (see Opium). 



Lead and its sol- 
uble salts. 



Inflammation of the 
throat, stomach, and in- 
testines, paleness, con- 
stipation, drawing in of 
belly, loss of voice, di- 
lated pupil, cold sweats, 
locked jaw, paralysis, 
violent convulsions, 
death. 



Put five tablespoonsful of Ep- 
som salts in a large tumbler of 
water, and give a wineglassful 
every ten minutes till it operates 
freely. 

White of eggs and milk in large 
quantities. 

Chloroform internally as before, 
until symptoms are relieved. 



Mercury. 

Corrosive Sub- 
limate. 



Styptic, metallic acid, 
taste, constriction and 
burning of throat, sali- 
vation, great anxiety, 
tearing pains in stomach 
and intestines, vomit of 
bilious and after some 
time bloody matter, di- 
arrhoea, small, quick, 
hard pulse, faintings, 
cramps, convulsions, 
coma, death. 



The whites of eggs well mixed 
with water in large quantities, 
and continued until the vomit 
becomes transparent. 

A mixture of soap and wheat 
flour in water. 

The warm bath. • 



1126 ACCIDENTS AND INJURIES. 


POISONS. 


SYMPTOMS. 


ANTIDOTES. 


Mushrooms. 


Nausea, vomiting, 
purging, colic, cramps 
of lower extremities, 
excessive thirst, convul- 
sions, coma, death, or 
aggravated cholera mor- 
bus. 


Brisk vomiting to be produced 
if the irritating substance has not 
been freely rejected, and then a 
purgative given. 

Chloroform internally as before. 


Nux Vomica. 
Strychnia. 


Twitchings, rigidity 
of extremities, alternat- 
ing with trembling, diffi- 
cult respiration, excru- 
ciating pain in the stom- 
ach, suffocation, and 
death. 


Evacuate stomach by pump, 
give chloroform internally in tea- 
spoonful doses, frequently repeat- 
ed, until symptoms are relieved. 

Tannin in excess 20 or 25 times 
that of the poison taken. 


Opium and its 
preparations, 
laudanum, etc. 

Henbane. 


Giddiness, stupor not 
always preceded by ex- 
citement, slow breath- 
ing, closed eyes, pupils 
contracted, features 
ghastly, pulse feeble and 
imperceptible, delirium, 
cold sweat, relaxed 
muscles. 


Instant removal of poison by 
active emetics and stomach-pump, 
cold douche. Belladonna freely 
exhibited, of the tincture a tea- 
spoonful, or of the extract two 
grains, every twenty minutes un- 
til free vomiting is established. 
Artificial breathing, strong coffee, 
active stimulants, decoction of 
galls, electro-magnetism, constant 
motion. 


Savine. 


High excitement, with 
acute pain in stomach 
and bowels, nausea, and 
vomiting, convulsions, 
and in pregnant females 
abortion. 


Emetics, copious dilutions with 
barley-water, sedatives, emol- 
lients, paregoric. 


Silver, Nitrate 
of. 

Lunar Caustic. 


Pains in stomach and 
abdomen, .constriction 
and burning in throat, 
salivation, vomiting of 
bloody matter, diarrhoea, 
breathing greatly em- 
barrassed. 


Strong solution of common salt 
which converts it into chloride of 
silver, emetics, strict antiphlogis- 
tic treatment. 


Tin, Salts of. 


Vomiting, acute pain 
in the stomach, anx- 
iety, restlessness, thirst, 
frequent, hard and small 
pulse, increasing symp- 
toms of violent irrita- 
tion, delirium. 


Free vomiting, use of the 
stomach-pump. 

Whites of eggs, or milk in 
large quantities. 





BURKS AND SCALDS. 



1127 



POISONS. 



SYMPTOMS. 



ANTIDOTES. 



Zinc, Sulphate 
of. 



Quickened pulse, pale 
and shrunken features, 
cold extremities. 

Death rarely follows, 
on account of the severe 
vomiting induced in 
the first instance. 



Milk decomposes the poison, 
and should be administered in 
large quantities. 



Bukxs and Scalds. 

The only difference between a burn and a scald is 
that the first is the result of a dry heat and the second 
of moist heat. 

Burns and scalds are of very common occurrence, 
and occasion a very large amount of suffering. Many 
accidents of this sort might be avoided by proper 
care. As Dr. Hope says : The number of children 
who die from these causes is dreadful ; but when we 
consider the love of playing with fire common to all 
children, the absurd and dangerous fashion of having 
the dress swelled out with crinoline when cooking or 
doing anything near a fire, the careless manner in 
which lucifer matches are carried loose in pockets and 
dropped on to floors, or the way in which hot liquids 
are placed in the way of children, the wonder is that 
they do not happen more frequently. 

Putting Old the Fire. — Take this case, a description 
of what is unfortunately happening every day: A 
woman's clothes take fire ; she is wrapped in flames ; 
her arms and hands, her neck and face, are scorched 
with the heat; her hair is in a blaze; the smoke is 



1128 ACCIDENTS AND INJURIES. 

suffocating her. She becomes utterly confused, and 
rushes to and fro, so creating a current of air which 
increases the fire. The best thing she could have 
done would have been instantly to roll upon the floor. 
But how few would have presence of mind to do this ! 
The more need for a friend to do it for her. Seize her 
by the hand, or by some part of the dress which is not 
burning, and throw her on the ground. Slip off a 
coat or shawl, a bit of carpet, anything you can 
snatch up quickly, hold this before you, clasp her 
tightly with it, which will protect your hands. As 
quickly as possible fetch plenty of water; make 
everything thoroughly wet, for though the flame is 
out, there rs still the hot cinder and the half-burnt 
clothing eating into the flesh ; carry her carefully into 
a warm room, lay her on a table or on a carpet on the 
floor — not the bed — give her some warm stimulating 
drink, send for the doctor, and proceed to the next 
operation — 

Removing the Clothes. — Perhaps in the whole course 
of accidents there is not one which requires so much 
care and gentleness as this. "We want only three 
people in the room — one on each side of the patient, 
and one to wait upon them. Oh, for a good pair of 
scissors or a really sharp knife ! "What misery you will 
inflict upon the sufferer by sawing through strings, 
etc., with a rough-edged, blunt knife ! There must 
be no dragging or pulling off; do not let the hope of 
saving anything influence you. Let everything be so 
completely cut loose that it will fall off; but if any 



BURNS AND SCALDS. 1129 

part stick to the body, let it remain, and be careful 
not to burst any blisters. 



THE TREATMENT 

Of burns and scalds varies with the degree of the 
injury done. 

When the skin is not blistered nor broken, but 
merely reddened, the best application is creasote-water 
(to be obtained of the druggist, made by adding two 
drops of the oil of creasote to the ounce of water), to 
be sponged over the part. It gives relief to the 
pain at once. 

If the skin be blistered or destroyed by the heat, a 
mixture of linseed oil and lime-water upon a piece of 
old linen, covered with a piece of flannel and secured 
by means of a bandage, is an old and approved 
method of treatment. 

A poultice of scraped potato-apple or turnip makes 
a pleasant application when the burn is not very 
severe. 

Carded cotton is an excellent American remedy. 

Prof. Gross, the distinguished Professor of Surgery 
in the Jefferson Medical College, has strongly recom- 
mended ordinary white-lead paint as a most useful 
application in all cases. He says of it: "From its 
great efficacy, and the readiness with which it can 
usually be employed, this mode of treatment deserves 
to come into more general use. It is not applicable 
merely to the milder forms of burns and scalds, but it 
may often be advantageously used, no matter what 



1130 



ACCIDENTS AND INJURIES. 



may be the extent or depth of the injury. As the 
lead of the shops is very stiff, and, consequently, unfit 
for use, my invariable plan is to incorporate with it a 
sufficient quantity of linseed oil to make it of the 
consistence of thick cream. Thus prepared, the 
affected surface is thickly and thoroughly coated with 
it by means of a large camel-hair pencil, a soft mop, 
or a small paint-brush. If vesicles exist, their contents 
are evacuated with a fine needle, and the parts are 
well dried; otherwise the lead will not adhere. The 
dressing is completed by covering the painted surface 
with a layer of carded cotton, or a piece of old muslin 
or linen, supported by a moderately firm roller. In 
mild cases, one application of this kind, allowed to 
remain on four or five days, will usually suffice to effect 
a cure. In the more severe forms of the lesion, on the 
contrary, a considerable number may be required. 
"Whenever the dressings become stiff or saturated 
with secretions, they should be removed, others being 
immediately substituted. 

"I have never witnessed any bad effects from white- 
lead paint, applied as here stated, although I have 
used it very freely in quite a number of cases. In 
one instance, that of a negro girl, sixteen years of age, 
who had a most severe and extensive burn of the neck, 
chest, and abdomen, I maintained the application 
upwards of five weeks, consuming more than a quart 
of the lead, without observing the slightest injury. 
In short, my experience induces me to believe that 
the treatment is perfectly safe in all cases, whatever 
may be the extent or depth of the lesion, or the age 



RAILROAD A:NT> OTHER INJURIES. 1131 

of the patient. "Where a counter-poison, however, is 
deemed necessary, it will be readily found in the occa- 
sional exhibition of a dose of sulphate of magnesia, 
which, while it keeps the bowels in a soluble state, 
combines with the lead, forming an inert sulphate. 

" "White-lead paint probably produces its good 
effects in two ways: first, by forming a varnish to 
the affected surface; and, secondly, by directly obtund- 
ing its nervous sensibility. In many cases it acts 
literally like a charm; the patient, in a few moments, 
becoming perfectly calm, and passing, as it were, from 
torment into Elysium." 

Subnitrate of bismuth, rubbed up in a mortar with 
glycerine so as to make a thick paint, and spread over 
the parts, which are afterwards covered with carded 
cotton, confined by a roller bandage, is a soothing 
application. 

Railroad axd other Injuries. 

Dr. John H. Packard has prepared an admirable 
series of short rules for the course to be followed by 
bystanders in case of railroad injury, when surgical 
assistance cannot be at once obtained. These rules 
should find a place in every depot, foundry, and work- 
shop in the country. 

The dangers to be feared in these cases are : Shock 
or collapse, loss of blood, and unnecessary suffering in 
the moving of the patient 



1132 ACCIDENTS AND INJURIES. 



I. SHOCK. 

In Shock the injured person lies pale, faint, cold, 
sometimes insensible, with labored pulse and breath*- 
ing. 

Apply external warmth, by wrapping him up (not 
merely covering him over) in blankets, quilts, or extra 
clothes. Bottles of hot water, hot bricks (not too 
hot), may also be wrapped up in cloths and put to the 
armpits, along the sides, and between the feet if they 
are uninjured. 

If the patient has not been drinking, give brandy 
or whiskey, in tablesjpoonfal doses every 15 or 20 
minutes — less frequently as he gets better. Food 
(strong soup is the best) should also be given now 
and then. 

II. LOSS OF BLOOD. 

If the patient is not bleeding, do not apply any 
constriction to the limb, but cover the wounded part 
lightly with the softest rags to be had (linen is the 
best). 

If there is bleeding, do not try to stop it by binding 
up the wound. The current of Hood to the part must 
he checked. To do this, find the artery, by its beating; 
lay a firm and even compress or pad (made of cloth or 
rags rolled up, or a round stone or piece of wood well 
wrapped) over the artery (see Fig. 1); tie a 
handkerchief around the limb and compress; put a 
bit of stick through the handkerchief and twist the 



HOW TO TRANSFER A WOUNDED PERSON. 1133 

latter up until it is just tight enough to stop the bleeding ; 
then put one end of the stick under the handkerchief, 
to prevent untwisting (as in Fig. 2). 

The artery in the thigh runs along the inner side 
of the muscles in front, near the bone. A little above 
the knee it passes to the back of the bone. In 
injuries at or above the knee, apply the compress high 
up, on the inner side of the thigh, at the point where 
the two thumbs meet at C, in Fig. 3, with the knot on 
the outer side of the thigh. When the leg is injured 
below the knee, apply the compress at the back of the 
thigh, just above the knee at C, in Fig. 4, and the 
knot in front, as in Figs. 1 and 2. 

The artery in the arms runs down the inner side of 
the large muscle in front, quite close to the bone; low 
down it gets further forward toward the bend of the 
elbow. It is most easily found and compressed a 
little above the middle. (See Fig. 5.) 

Care should be taken to examine the limb from time 
to time, and to lessen the compression if it becomes 
very cold or purple; tighten up the handkerchief 
again if the bleeding begins afresh. 

in. TO TRANSPORT A WOUNDED PERSON 
COMFORTABLY. 

Make a soft and even bed for the injured part, of 
straw, folded blankets, quilts, or pillows laid on a 
board, with side-pieces of board nailed on, where this 
can be done. If possible, let the patient be laid on a 
door, shutter, settee, or some firm support, properly 



1134 ACCIDENTS AND INJURIES. 

covered. Have sufficient force to lift him steadily, 
and let those who bear him not keep step. 

Bleeding- at the Nose. 

The application of cold to the nape of the neck, 
and over the bridge of the nose, will usually stop the 
bleeding. A large bladder filled with ice may be used 
over the back of the neck, and a lump of ice wrapped 
in flannel over the nose. Hot foot-baths are also 
sometimes useful. 

In mild cases, the closing of the bleeding nostril 
with the fingers of the opposite side, and the holding 
upright of the arm of the bleeding side, will check 
the flow of blood. 

The injection up the nostrils of a solution of alum 
and water will act as an astringent. The insertion of 
a piece of ice into the affected nostril, or the holding 
of it against the roof of the mouth, is a useful and 
easy method of treatment. 

To check Weeding from the lungs, see the directions 
given on page 932. 

Foreign Bodies. 

Foreign substances of many kinds may enter the 
eyes, nose, throat, ears, etc., and, remaining there, 
cause serious trouble. 



THINGS IN THE EYE, NOSE, AND EAR. 1135 
THINGS IN THE EYE. 

The most convenient plan when bits of cinder, or 
similar bodies, get in the eye, is to shut the eye, pass 
a bodkin under the lid, press gently upon it with your 
finger, and, pushing outwards against the lid with 
the bodkin, sweep the little nuisance into the inner 
corner of the eye, whence it can readily be lifted with 
the corner of a handkerchief. The head of a smooth 
pin, or any similar article, will serve as well as a bod- 
kin. 

Simply lifting the upper lid away from the eyeball, 
by taking hold of the eyelashes, and drawing it down 
over the lower lid, will often suffice. 

THINGS IN THE NOSE AND EAR. 

If in the nose, take a pair of small pliers, put the 
points in the nostril, and open them gently across the 
face; at the same time put the finger above the sub- 
stance, and press it down where the pliers can close 
upon it. A pinch of snuff will often cause the sub- 
stance to be expelled with a sneeze. 

Syringing with warm water is the only safe way to 
remove things from the ear. If that fails, consult a 
doctor. In case it is an insect of some kind, fill the 
ear at once with oil, which will promptly kill the 
intruder. 



1 



1136 



ACCIDENTS AND INJURIES. 



FOREIGN BODIES IN THE THROAT. 

Anything remaining in the throat causes choking 
and distressing cough. 

When a person chokes, give him a smart slap 
between the shoulders; this will often cause him to 
eject the substance from his mouth. A teaspoonful 
of mustard and water will often cause him to vomit, 
and thus throw it up. Do not delay too long, how- 
ever, to call in the aid of a surgeon, if one is obtain- 
able. 

Bruises. 

The discoloration of the skin which follows a blow 
or fall is often more disagreeable than the pain imme- 
diately felt. This can be avoided by a simple treat- 
ment. After receiving a violent blow or fall, likely 
to be followed by such a consequence, the treatment 
is to apply at once a lotion of whiskey, alcohol, or 
some other strong liquor, constantly to the part. 
This will not only relieve the pain and soreness, but, 
if immediately and steadily applied, will do away with 
all tendency to the " black and blue" appearance which 
is so annoying. 



Fainting. 

The very common accident of a person fainting may 
arise from a variety of causes, but the proper treat- 
ment in all cases is the same. 

The patient, should at once be laid flat upon the 



FAINTXKG. 1137 

back, the head not elevated but on a level with the 
body; the clothing should be loosened, especially 
around the neck and chest; fresh air should be 
allowed free access to the face, a fan being used if at 
hand; and cold water should be sprinkled with some 
force upon the face and throat. The crowd which 
often collects should be requested to depart, and if a 
close room has produced the attack, the sufferer should 
be taken to the open air. 




72 



APPENDIX. 




(See page 771.) 






FOBMtfLM 






R. Pulv. opil 


gr. h 




Pot. bromid. 


gr. x. 




Pulv. aromat. 


gr. xij. 




M. 






R. Pulv. cat. comp. (Dub.) 






R. Pulv. rhei 


gr. ij- 




Pulv. podophyl. extr. 


gr. |. 




Sod. et pot. tart. 


3ij. 




M. 






R. Hydrarg. sulpli. flav. 


gr. v. 




R. Ammon. muriat. 






Pulv. rad. seneg. 


aa gr. x. 




Pulv. acac. 






Pulv. glycyrrhiz. 


aa gr. xij. 




M. 






R. Ammon. carb. 






Zingib. pulv. 


aa gr. xij. 




M. 




• 


R. Ferri sulpli. granulat. 


gr. iij. 




Pulv. aloes Socot. 


gr- J- 




Pulv. calumb. 






Pulv. cinnamom. 


aa gr. v. 




M. 







1140 APPENDIX. 

R. Pulv. ipecac comp. 

Pulv. potas. nit. 

Pulv. aromat. aa gr. v. 

M. 

R. Potass, acetat. gr. x. 

Pulv. fol. uvse ursi. gr. xxx. 

M. 

R. Chinoidise gr. xv. 

R. Santonin. 

Pulv. aromat. 
M. 

R. Acid, carbolic, puris. 

Adipis vel cer. simp. 

01. geran. 
M. 

R. Sulph. prsecip. 
Potass, nitrat. 
M. 

R. Pot. iodid. 

Ammon. muriat. 

Pulv. zingib. 
M. 




gr. iy. 
gr. x. 


gr. v. 

gss. 
gtt. iij 


S3- 


gr. x. 
gr. v. 
gr. x. 








INDEX 



ABDOMEN", contents of, 607 
position, 612 
Acidity of the stomach. (See Heart 

BURN.) 

Acids, poisonous, 1124 
Aconite, antidote for, 1125 

lotion of, 526 
Adulterations of bread, 88 

of arrowroot, 89 

of butter and cheese, 89 
Aged, care of the, 593 

(See Old Age.) 
Ague, how to avoid, 593 

remedies for, 703, 726, 729, 730, 
731, 735 

description and treatment, 757 
Ague-cake, 646 
Alcohol, medical properties, 694 

is it useful, 108 

dangers of, 104, 269, 284 
Alkaline baths, 461 

waters, 649 

treatment, 815 
Almonds and milk, 513 
Aloes, medical properties, 748 
Alum, medical properties, 698 

burnt, 700 

curd, 699 
Anaesthetics explained, 685 
Animal food, kinds of, 55 
Anodyne explained, 685 
Antidotes to poisons, 1123 
Antimony, antidotes for, 1124 
Apoplexy, prevention of, 267 

description and treatment, 1026 
Apothecaries' weights and measures, 

553, 691 
Apparently drowned, to restore, 1117 
Appetite in disease, 631 

loss of, 577 
Apple poultice, 519 

with crumbs, 508 
Arnica, solution, 528 



Aromatic syrup of rhubarb, 758 

sulphuric acid, 261 
Arrowroot, adulterations of, 89 

pap, 404, 407 
Arsenic in wall paper, 157 

as a medicine, 868, 927 

antidotes for, 1124 
Arteries, position of, 1132 
Assafcetida, 749 
Ass's milk, 793 

artificial, 501 
Asthma, description and treatment, 
890 

remedies for, 713, 738, 741, 745 

(See Hay Asthma.) 
Astringent explained, 685 
Atlantic States, the climate of, 630 
Atomization of medicines, 688 



BARBER'S tetter, 1077 
itch, 1086 
Barks, to preserve, 724 
Barley-water, 401, 512 
Bath, the warm, 396, 453 

the hot, 455 

the cold, 396, 456 

the local, 456 

the dry heat air, 468 

sitz-bath, 457 

the shallow, 457 

acid, for the feet, 457 

alkaline, 461 

sulphur, 461 

the vapor, 466 

the douche, 459 

the shower, 465 

medicated, 396, 460 

Turkish, 463 
Bathing in children's diseases, 393 
Bearberry, virtues of, 726 
Bed, the, of a sick child, 398 

and bedclothino-, 192 



( 11" ) 



1142 



IOTDEX. 



Bedding for an invalid, 432 
Bedfellow, the, 194 
Bed-sores, to prevent, 696 
Bed-wetting in children, 1068 
Beef, as a food, 57 

tea, receipts for, 490 
soup, receipt for, 493 
Beer, ginger, 705 
Behavior in a sick-room, 637 
Belladonna, uses, 749 
antidote for, 1124 
Belly, the, 376 
Bile, the, 995 
Biliousness, nature and remedies, 378, 

626, 632, 704, 736, 761 
Bisulphites, the, 237 
Bites of mad dogs, 265 

of serpents, 697, 711, 1123 
Blackberry, uses- of, 728 
Black elder, uses of, 727 
Black eyes, to treat, 696 
Bladder, inflammation of, 733, 736, 
1091 
diseases of, 1087 
Bleeding after death, 325 
to stop, 698, 1132 
of the nose, 698, 1134 
from lungs, 703, 730, 932 
piles, 698 
Blindness, to treat, 676 
Blisters, how to apply, 531 

to dress, 532 
Blistering tissue, 534 
Blood, vomiting of, 698 
loss of, 1134 
circulation of, 608 
color of, 609 
Bloody flux. (See Dysentery.) 
Blue disease, the, 365, 942 
Body, height and weight of, 614 
Boils, to treat, 1096 
Bones, description of, 604 

in old age, 291 
Boots, proper shape of, 125 

tight, hurt the eyes, 283 
Borax, medical uses of, 700 
and glycerine, 527 
hath of, 462 
Bowels, constipated. (See Consti- 
pation.) 
action of, 634 
position of, 61 2 
Boxing, as an exercise, 178 
Brain, diseases of, 367 
Bran bread, 506 
poultice, 521 
Brandy and egg mixture, 502 
Bread, as a food, 76, 480 
of bran, 506 
jelly, 509 
pudding, 507 
poultice, 518 



Breath, odor of, 626 

Breathing, diseases of organs of, 627 

Bright's disease of kidneys, 1089 

Brinton, Dr. D. G., 660 

Bromide of potassium, 472, 759 

of ammonium, 817 
Bronchitis described, 869 

(See Coughs and Colds.) 
Broths for the sick, 494 
Brow-ague, 1005 
Brown-Sequard, remedy for epilepsy, 

1020 
Bruises, to treat, 696, 791, 1136 
Buckwheat cakes, effects of, 278 
Building, choice of site, 156 

materials for 136 
Bunions, to treat 1103 
Business, when to retire from, 304 
Burdock, uses of, 728 
Burial, premature, 319 
Burning the dead, 345 
Burns and scalds, treatment of, 696, 

701, 704, 709, 727, 1127 
Burnt alum, 700 
Butter, uses of, 56, 478 

adulterations of, 89 
Buttermilk in fevers, 478 
Butternut, the, 733 



flALAMUS, 730 
\J Calomel, 760 
Calves' foot jelly, 510 

feet in milk, 495 
Camphor, 750 
Camp itch, 1075 
Cancer, how to tell, 1105 
Cantharidal collodion, 533 
Carbolic acid, as a disinfectant, 229 
as a medicine, 761 
soap, 527 
in smallpox, 848 
Carbonate of iron, 1009 
Carbonated waters, 649 
Carbuncle, how to treat, 1098 
Cast-iron stoves, injurious, 249 
Castor oil, uses of, 751 

injection of, 547 
Catalepsy described, 1022 
Catarrh of the chest, 875 
Catarrhal fever, 861 
Cathartic explained, 685 
Caudle, receipt for, 504 
Celibacy, influence on life, 49 
Cellar, how to build, 138 
Cemeteries, their location, 341 

exhalations from, 343 
Chalybeate springs, 644 
Chamber for sleeping, choice of, 195 

for a sick child, 381 
Chamois leather drawers, 1007 
Charcoal, medical uses, 702 



INDEX. 



1143 



Charcoal — 

poultice, 521 

as a disinfectant, 232 
Cheese in sickness, 479 
Chest, contents of, 608 
Chickenpox described, 1052 
Chilblains, 1116 
Children, nursing of, 351 

to tell diseases in, 354 

position, when sick, 357 

loss of flesh, 360 

expression, when sick, 362 

cry of, when sick, 367 

cough of, when sick, 369 

other symptoms, 370, 379 

in the sick-room, 579 

amusing them when sick, 588 

diseases of, described, 1047 
Childishness, signs of, 301 

lis and fever d 

to avoid, 250 

remedies for, 703, 726 

(See Ague.) 
Chloral, as a medicine, 762 
Chlorate of potash, 763 
Chloroform, 685, 896 
Chocolate, as a beverage, 101 
Choking, 1136 
Cholera, to avoid, 258 

description and treatment, 945 

is it contagious, 948 

drops, 262 - 

infantum, 409, 1063 
Cholerine, 260 
Chronic diarrhoea, 987 
Cider as preventing ague, 257 

vinegar, 527 
Cinnamon, uses of, 751 
Cleanliness, importance of, 133, 383, 
392 

of sick-room, 443 
Cleavers, medical uses of, 729 
Climate, influence on longevity, 47 

change of, in disease, 655 
in consumption, 926 

of the United States, 657 

most healthful warm, 659 
Clothing, materials of, 120 

color of, 121, 278 

in consumption, 925 

for underwear, 124 

at night, 193 

effect of too much, 155 

of a sick person, 470 

in skin diseases, 278 

removal of, 1128 
Clysters, receipts for, 514 

(See Injections.) 
Coal oil, uses of, 256, 701 
Cocoanut oil 1009 
Cod-liver oil, uses of, 793 

in consumption, 927 



Coffee, adulterations of, 92 

as a beverage, 100 

in asthma, 895 

in neuralgia, 1010 

to allay hunger, 117 
Coffins, materials for, 341 
Cold affusion, 458 

injuries from, 1113 

in the head, 707, 755, 857 

on the breast, 734, 869 

in children, 368 

(See Coughs.) 
Colic remedies, 711, 742 
Collodion, 528 
Color, in death, 323 

of clothing, 121, 278 

of stools, 379 
Confection of senna, 758 
Confectionery, poisonous, 78 
Constipation cured by movements, 668 

described, 973 

in old age, 290, 984 

remedies for, 736 
Consumption, to prevent, 202 

description and treatment, 904 

is it contagious, 909 

symptoms of, 912 

diet in, 919 

climates for, 926 
Contagious diseases defined, 784 
caught from corpses, 339 
how to avoid, 226, 585 
Convulsions. (See Fits.) 
Cookery, the value of, 87 

of meats, 67 

for the sick, 477, 489 
Copper, danger of working in, 223 

antidotes for, 1125 
Corn bread, 507 
Corn-meal as food, 77, 507 

gruel, 505 
Corn-starch, 506 
Corns, how to cure, 1109 
Corpse, care of, 331, 578 

how to keep, 333 

diseases caught from, 339 
Corrosive sublimate, antidote for, 1125 
Cotton, as clothing, 121 

medical uses, 1129 
Cough, in children, 368 

of long* duration, 370 

treatment, 389 

kinds of, 627 

remedies for, 718, 722, 734, 744, 
746, 871, 930 
Counter-irritation, 929 
Crab lice, to destroy, 761 
Cracker pudding, to make, 508 
Cramp colic, to cure, 711 
Cream of tartar, medical properties, 

704 
Creasote- water in burns, 1129 



1144 INDEX. 


Creasote-water — 


Domestic plants, virtues of, 723 


bath, 462 


when and how to gather, 725 


Crele, Joseph, 405 


Doses of medicines for children, 548 


Croton oil, 929 


for adults, 550 


Croup, cough in, 368 


Douche bath, 450 


bathing in, 396 


Dover's powders, 756, 862 


true, 1055 


Dreams, bad, to prevent, 190 


false, 1057 


Dressing gowns, 590 


remedies for, 699, 708, 1056 


Drinks of a sick child, 401 


Cure, natural means of, 643 


temperance, 102 


Swedish movement, 663 


Drowned, to restore the, 1117 


Cupping, directions for, 543 


Dropping lotions in the eye, 586 


Cushions for sick-room, 430 


Dropsy, remedies for, 704, 707, 711 




728, 730, 740, 741, 752 




Drunkenness, cure of, 109 


TkANCHSTG- as an exercise, 177 
JJ Dandelion, uses of, 736 


Dumb shakes, the, 640 


Duty of amusing children, J588 


Dandruff, to cure, 1083 


Dwelling-houses, to build, 136 


Deadly nightshade, 749 


how to light, 143 


Deafness, treatment of, 677 


warm, 153 


Death, fear of, 308 


furnish, 160 


pain of, 311 


ventilate, 149 


sudden, and its causes, 312 


dangers of newly -built, 162 


signs of approaching, 315 


Dyes, dangerous, 278 


presentiments of, 318 


Dysentery, to prevent, 272 


signs of actual, 326 


description and treatment, 988 


rigidity of, 332 


remedies for, 701, 702, 719, 728, 


rattle, 315 


731, 753, 992 


Decoctions, 689 


Dyspepsia, prevention of, 269 


Decomposition, signs of, 329 


treated by movements, 670 


Decrepitude, prevention of, 285 


description and treatment, 954 


Delirium, treatment, 568 


remedies for, 711, 722 


tremens, 712 




Dengue, the, 640 




Deportment about the dying, 584 


T7AE, things in the, 1135 
JJ Earache, signs of, 367 


Deviled biscuits, 280 


Dewberry, the, 728 


treatment, 1109 


Diabetes, 1087 


Earth, as a disinfectant, 232 


Diaphoretic explained, 685 


Earth-closet, the, 233 


Diarrhoea, description and treatment, 


Eating too much, 954 


985 


Ecstasy, 1024 


' in children, 378, 395 


Eggs as food, 51, 416, 479 


remedies for, 701, 719, 728, 730, 


Elder, black, 727 


731, 933 


Electricity, medical uses, 673 


prevention of, 272 


diseases benefited by, 675 


Diet in sickness, 483 


Elixir of life, 287 


in scurvy, 801 


Embalming, art of, 337 


drinks, 401 


English porridge, 500 


in epilepsy, 1020 


Enlarged heart, 935 


Digestion, organs of, in disease, 629 


Epilepsy, prevention of, 214 


Diphtheria, 708 


description and treatment, 758, 


Disease, distribution of, 638 


1012 


Diseases, to distinguish, 621 


Epileptic aura, 1017 


to avoid catching, 227 


Epsom salts, 765 


incurable, 619 


Eruptions on the skin, 636 


Disinfectants, use of, 228, 335 


Erysipelas, 701, 1093 


in disease, 846 


Essence of beef, 492 


Diuretic explained, 685 


Ether, 896 


Dizziness, to prevent, 267 


Exercise, in convalescence, 418 


Dogwood, uses of, 729 


objects of, 168 


Dogs, mad, 265 


principles of, 170 


worms from, 275 


of the sick, 470 



INDEX. 1145 


Exercise — 


Fruit as food, 78 


in consumption, 207, 973 


Furniture of sick-room, 423 


in old age, 293 




mental, 298 




Expectation of life, tables, 616 


p ALLIC acid in bleeding of lungs, 
VI 932 


Expectorant described, 685 


Expectoration, character of, 627 


Gallium, aperine, 729 


External location of parts, 612 


Gall-stones, 650 


Extracts, 690 


Game as food, 63 


of beef, 492 


Gargles, 699, 763, 709 


Eyes, to prevent diseases of, 280 


Garlic, medical uses, 738 


in death, 328 


Gas, carbonic acid, 1125 


weakness of, 677 


Gelatine food, 456 


sore, 699 


Gestures in sickness, 359 


inflammation of, 1107 


Giuger, its medical uses, 274, 705 


things in, 1135 


Glycerine, 527 


Eyesight, to preserve, 281 


Goose-grass, 729 


in old age, 302 


Gout, to prevent, 216, 650 




Granules, 691 




Gravel, remedies for, 650, 713, 715, 




726, 729 


T7ACE, neuralgia of, 1004 

T Fainting, treatment of, 564, 1136 


Green wall-paper poisonous, 157 


sickness, 631 


Falling sickness. (See Epilepsy.) 


Grocer's itch, 279, 717 


Febrifuge explained, 655 


Gruels, receipts for, 403, 492, 505 


Feeble-minded, care of, 599 


Gums in disease, 629 


Feet, coverings for, 125 


Gutta-percha liquor, 1108 


Felons, 1099 


Gymnastics, 176 


Fever and ague. (See Ague.) 




signs of, in children, 371 


" 


food in, 411 


TTABITS, indolent, 975 
fl Hair, to care for, 130 


blisters, 1079 


catarrhal, 861 


Hand-ball atomizer, 688 


Figs, uses of, 523 


Havelock, the, 1113 


Fish, as a diet, 63 


Hay asthma, 865 


at times poisonous, 68 


Head, covering for, 122 


Fits, in children, 63 


cold in, 859 


treatment of, 379 


Headache, 759, 1005 


epileptic, 1012 


Health, conditions of, 46 


Flatulence, 968 


Hearing, to preserve, 303 


Flaxseed, uses of, 567 


in fevers, 625 


poultice, 519 


Heart, diseases, to prevent, 215 


Fleabane, uses of, 737 


described, 935 


Flooding, to treat, 738 


symptoms, 418, 628 


Florida, climate of, 296, 649, 661 


remedies, 752, 937 


Fluid extracts, 690 


Heartburn described, 633, 650, 956 


Flux, bloody. (See Dysentery.^ 


remedies for, 707, 710, 714 


Fomentations, 814 


Hemlock, 1011 


Food, quantity to take, 83, 582 


bath, 462 


adulterations, 88 


Henbane. (See Opium.) 


varieties, 55 ■ 


Herbs, when to gather, 725 


for children, 406 


Hereditary tendencies, 48 


rules for giving, 486 


diseases, to prevent, 201 


Foot-warmer, 428 


Hives, 710, 1074 


Forehead, neuralgia of, 1005 


Hoarseness, 744 


Foreign bodies in nose, 1134 


Hog-apple, 742 


Formulas, 1136 


Hooping-cough. (See Whooping- 


Fowls as food, 62 


cough.) 


Foxglove, medical uses of, 752 


Horseradish, virtues of, 739 


Freckles, 1071 


aloes, 798 


Freezing mixture, 524 


Hot water in medicine, 722 


Frosted feet, 703, 1114 


springs, 647 



1146 IITOEX. 


Houses, how to build, 136 


TfEROSENE, to detect dangerous, 
IV 148 


materials for, 137 


Hunger and thirst, 116 


Kidneys, in disease, 635 


Hydrophobia, prevention and treat- 


position of, 612 


ment, 265 


diseases of, 1087 


Hygiene, principles of, 41 


skim milk in, 478 




remedies for, 650, 729, 730, 




1088 


TCELAND moss jelly, 510 
1 Idiotic, care of, 599 


Kitchen, how to build, 161 


Kneading the abdomen, 669 


Inanition, 305 




Incurable diseases, 619 




Indian tobacco, 741 


T ACTUCARIUM, 740 
JJ Laudanum, 754 


Indigestion. (See Dyspepsia.) 


Inebriate, care of, 109, 602 


Lead-poisoning, from water, 96 


asylum, 110 


from paint, 222 


Infectious diseases, 784 


remedies for, 676, 699, 1125 


Infirm, care of, 593 


Leeches, to apply, 535 


Inflammation of lungs, 882 


to handle, 537 


Inflammatory rheumatism. (See 


to remove, 540 


Rheumatism. ) 


Lemonade, as a beverage, 103 


Influenza, 707, 850 


Lemon-juice, medical uses, 706 


Infusions described, 680 


in rheumatism, 816 


Injections, to administer, 545 


Leprosy, 1083 


receipts for, 547 


Lettuce, medical uses, 740 


nutritious, 514 


Lichen, 1074 


of milk, 952 


Liebig's soup, 408 


Insane, care of, 596 


Life, expectation of, 617 


asylums, 212 


signs of a long, 50 


Insanity, to prevent, 208 


rules for prolonging, 287 


from indigestion, 210 


Lifter, for an invalid, 432 


childbed, 211 


Lifting cure, the, 671 


examples of, 213 


Light, in a house, 143, 745 


Invalid, how to examine, 622 


in a sick-room, 441, 388 


Iodine, 795, 814 


artificial, 146, 249 


Iodide of potassium, 902 


Lime, medical uses, 708 


Ipecac, uses of, 753 


water, 709 


Irish moss jelly, 510 


Linen clothing, 121 


blanc mange, 504 


Liniments, receipts for, 529, 718, 1010 


Iron, medical uses of, 763 


Liver complaints, 994 


springs containing, 645, 764 


spots, 1071 


dangers from working in,- 224 


position, 612 


Itch, grocer's, 279, 717 


Lobelia, 741, 897 


barber's, 1086 


Lockjaw, 741 


true, 1084, 761 


Longevity, signs of, 50 


(See Camp Itch, Soldier's 


instances of, 44 


Itch.) 


Looseness of bowels. (See Diar- 


Itching, causes of, 277 


rhoea.) 


to allay, 527, 700 


Loss of flesh, 361 




of blood, 1132 




(See Bleeding.) 


JALAP, uses of, 753 
t) Jaundice described, 994 


Lotions, medicated, 525 


to allay itching, 527 


remedies for, 736, 934 


Lugol's solution, 796 


Jellies in sickness, 481 


Lumbago, 819 


receipts for, 510, 511 


Lunar caustic, antidotes, 1126 


Jenkins, Henry, his age, 44 


in disease, 929 


Jenner, Dr., 828 


Lungs, position, 612 


Jerusalem oak, 746 


inflammation, 882 


Jimson weed, 744, 896 


signs of, 366, 368, 883 


Juniper, 729 


treatment, 885 



index. 1147 


MACARONI, to prepare, 503 
ill Magnesia, 764 


Nervous diseases, 999 


prostration, 645 


Magnetic wells, 646 


Nettle rash, 1073 


Malic acid, 257 


Neuralgia described, 999 


Man, form of, 604 


treatment, 678, 742, 750 


Mandrake, 742 


of the face, 1004 


Marasmus, 376, 1063 


New England-, most common diseases 


Marriage, effect on life, 49, 206 


in, 638 


May-apple, 742 


Night sweats, 720, 931 


Meals, hours of, 86, 485 


Nipples, chapped, 1047 


Measles, cough in, 369 


Nitre, medical uses, 713 


fever in, 372, 395 


in rheumatism, 816 


described, 1048 


in asthma, 895 


remedies for, 1049, 415 


Nitric acid, antidotes to, 1122 


Measures and weights, 553, 691 


Nitrate of silver, antidote to, 1126 


Meats, salted, 60 


Nose, things in, 1135 


fat or lean, 61 


Nurse, duties of, 573 


diseased, 65 


Nursing, notes on, 573, 590 


poisonous, 68 




Medicines, what they are, 681 




how they act, 683 


AAK-BARK, uses of, 730 
\J Oatmeal gruel, 402 


classified, 685 


how given, 687 


mush, 504 


domestic, 692 


Occupations and health, 204 


doses of, 548 


in consumption, 907 


to administer. 555 


Oil, castor, 751 


Mental exercise, 298 


olive, 711 


weakness, 299 


tansy, 746 


Mercury, as a medicine, 760 


Old age, natural progress of, 290 


as a poison, 1125 


proper diet in, 292 


Migraine, 1008 


physical exercise in, 293 


Milk, uses of, 55, 403, 478 


warmth in, 295 


poisonous at times, 70 


constipation in, 290, 984, 979 


skim, diet of, 478 


mental exercise in, 298 


diet in heart disease, 938 


eyesight in, 302 


toast, to prepare, 508 


hearing in, 303 


and iron, 502 


rejuvenation in, 305 


Milk-sickness described, 850 


colds in, 873 


its origin, 71 


catarrh in, 877 


Milk-crust in children, 1077 


chemical prevention of, 286 


Mind in disease, 625 


Olive oil, medical uses, 711 


Mineral springs, kinds of, 645 


Onion poultice, 521 


in dyspepsia, 970 


Opium, medical uses, 754 


advice to those using, 653 


eating and its cure, 114 


Mountain fever, 251 


poisoning and antidotes, 678, 750, 


Morphine, 754 


1126 


Movement cure, 663 


Organs, the, 606 


Mumps, 1053 


Overcoats, the best, 126 


Muriatic acid, antidote, 1122 


Overdone meat, 979 


Muscles, the, 606 


Oxalic acid, 1123 


Mushrooms, antidotes, 1126 


Oysters, to cook, 497 


Mustard, as a condiment, 82 




medical uses, 700 




poultice, 522 


PACIFIC States, climate of, 641 
JL Packing with wet sheet, 459 


Mutton as food, 58, 479 




Pain, signs of, 364, 371 




in stomach, 969 




Painter's colic, 221 


YTAILER'S consumption, 224 
1M Nature's calls, neglect of, 976 


Palsy, described and treatment, 675, 


1030 


Neatness of dress, 581 


remedies for, 740 


Neck, protection for, 123 


Panada, to prepare, 405 



1148 



INDEX. 



Paper-hangings, poisonous, 156 

Paps, receipts for, 407 

Paralysis. (See Palsy.) 

Parr, Thomas, his age, 44 

Parsley, uses of, 741 

Partridges, when poisonous, 70 

Patent medicines, 272 * 

Pepper as a condiment, 82 

Peppermint, uses of, 742 

Pepsine, 922 

Periods, suppressed, 746 

Permanganate of potash, 230 

Persimmon, medical uses, 731 

Peruvian bark, 756 

Petroleum, prevents ague, 256 
medical uses, 751 

Phosphorus, dangers from, 224 

Pigeon-berry, 731 

Piles, remedies for, 698, 732, 745, 1106 

Pillow-rests, 429, 434 
Pills, to make, 691 
Pimples, 700, 1026 
Pith of sassafras, 732 
Pitting in smallpox, to prevent, 848 
Plaster for corns, 1102 
Pleurisy, 879 
Plunge bath, the, 460 
Podophyllum, 742 
Poison-vine eruptions, 1080 
Poisons, antidotes to, 1121 
Poisonous milk, 70 
sausages, 70 
honey, 71, 73 
confectionery, 78 
flesh, 68 
wall-paper, 157 
Poke-weed, uses of, 731 
Poplar, American, 726 
Poppy, the, 754 
Pork, as food, 59 

diseased, 59, 69 
Porridge, to make, 500 
Potash, caustic, 1123 

chlorate of, 763 
Potatoes in scurvy, 805 
Potters, diseases of, 225 
Poultices, to prepare, 517 
receipts for, 519 
mustard, 522 
Powders, to make, 691 
Prickly heat, 1074 
Proud flesh, 700 
Prussic acid, 1122 
Puberty, hygiene of, 215 
Pulse of sick children, 371 

described, 623 
Purgatives, abuse of, 973 
Putrid sore throat, 704 

QUICKLIME as a disinfectant, 232 
Quinine, uses of, 756 
Quoit-playing, 158 



RACE, influence on life, 47 
Railroad injuries, 1131 
Rattlesnake bites, 1123 
Raw meat for children, 408 

produces tapeworms, 1065 
Ready method of disinfectk n, 231 
Recreation, importance of, 182 
Red gum in children, 1072 
Red pepper, medical use, 712 

weed, 731 
Respirator, 205 
Revaccination, 244 

(See Vaccination.) 
Rheumatism, description and treat- 
ment, 808 
in old age, 305 

remedies for, 708, 709, 713, 716, 
732, 740, 746 
Rhubarb, uses of, 757 
Rice pudding, 503 

water, 403 
Riches, advantage of, 50 
Rickets in children, 1064 
Riding as exercise, 174 
Ringworm, 700, 1086 
Roots, to gather, 724 
Rose (a skin disease), 1093 
rash, 1070 
cold, 868 
drop* 1081 
Round worms, 274, 1066 
Russian cholera drops, 262 
Rye as a food, 77 



CAGE, 743 
Sago, 405, 505 
Sal-ammoniac, 1010 
Saliva, in disease, 630 
Salt, as a condiment, 80 

medical uses of, 703, 932 

springs, 650 

bag, 1010 
Saltpetre, uses of, 713, 876, 895 
Sassafras, uses of, 732 
Savine, poisoning from, 1126 
Scabious, 737 

Scalds. (See Burns and Scalds.) 
Scald-head, 718, 1077 * 
Scarlatina, 

Scarlet fever described, 1049 
to avoid taking, 225 
fever in, 372 
treatment, 414, 1050 
School, going to, 419 
Sciatica, 701, 1006 
Scalloped oysters, 498 
Scorched bread, 703 
Scrofula, description and treatment, 
786 

to prevent, 207 
Scurf, 718 



INDEX. 



1149 



Scurvy, description and cure, 798 
Sea-sickness, to avoid, 279, 712 

voyage, benefits of, 282 

bathing, 651, 208 

■water, artificial, 463 
Seat worms, 704, 1064 
Second sight, 306, 
Seeds, to gather, 725 
Seltzer water, 650 
Seneka snakeroot, 744 
Senna, 758 

Serpents' bites, 697, 711, 1123 
Senses, special, 611 
Sesquichloride of iron, 1100 
Sex, influence on longevity, 48 
Shade trees, effects of, 144 
Shell-fish as food, 64 
Ship fever, 245 
Shivering, 565 
Shock, to treat, 1132 
Shoes, proper shape, 125 
Shower-bath, 465 
Sick-room, care of, 421 

furniture for, 423 
the model, Frontispiece. 
table, receipt for, 490 
Side, neuralgia of, 1006 
Sight, to preserve the, 281 

second, in aged, 306 
Skin, care of, 134 

in disease, 637 

diseases, to prevent, 275 
to cure, 1069 

discolorations of, 1076 
Skull, contents of, 610 
Sleep, to invite, 186, 471 

disturbed, 374 

necessity of, 184 

amount of, 185 

hours of, 186 

walking in, 197 
Slippery-elm, poultice, 519 

jelly, 511 
Smallpox, to avoid, 242 

description and treatment, 372, 822 

to prevent pitting, 841 

vaccination for, 243, 829 
Smell, loss of, 677 
Snake-bites, 697, 711, 1123 
Snakeroot, seneka, 744 

Virginia, 746 

white, 852 
Soap injection, 547 

carbolic acid, 527 

liniment, 529 
Social habits, 954 
Soda, bicarbonate of, 715 
Soda-water, 102, 715 

lozenges, 716 
Soldier's itch, 1075 
Solution described, 689 

of arnica, 528 



Sore mouth, 763 

throat, 743, 763 

eyes, 699 
Soup, receipts for, 493 

restorative, 493 

vegetable, 496 
oyster, 497 

tablets, 496 
Sour stomach, 968 

(See Heartburn.) 
South Carolina, climate of, 660 
Spanish cream, 500 
Spearmint, 742 
Spice belt, 273 
Spices as condiments, 80 
Spirits, depressed, 646 
Spitting of blood, 719, 932 
Spittle, the, 630 
Spleen, position of, 612 

enlarged, 646 
Sponge-bath, 450 
Spotted fever, 245 
Sprains, 696, 701 
St. Anthony's fire, 1093 
St. Yitus's dance, 396, 1032 
Standard domestic remedies, 767 
Starch as food, 74 

bath, 462 
Steam, medical uses, 722 
Stings of insects, 738 
Stomach, position of, 612 

pain in, 969, 366 

sour, 968 

warmer, 428 

ache, 366 
Stone in the bladder, 715 

(See Gravel.) 
Strychnine, poisoning by, 1126 
Stuping, 525 
Styes, to cure, 1097 
Suet pudding, 498 
Sugar of lead, 765 

as food, 75 

in urine, 1087 

adulterations, 91 
Sulphate of iron, 230 
Sulphur, as a disinfectant, 231 

medical uses, 716 

baths, 461, 716 

springs, 647 

ointment, 716 
Sulphuric acid, 1122 
Summer complaint, 1061 
Sunburn, 1070 

stroke, 1110 

pain, 1006 
Sunflowers as disinfectants, 255 
Swamp fevers. (See Ague, Chills 

and Fever. ) 
Sweating of feet, 700 

at night, 720, 931 
Swedish movement cure, 663 



1150 



INDEX. 



Sweet spirits of nitre, 238 

flag, 735 

oil, 711 
Swellings, to treat, 750 
Swimming, 177 
Syrup of lime, 709 

of ginger, 706 

of lemon, 707 

of wild cherry, 734 



TABLE oil, 711 
1 Tamarind-water, 512 
Tan on the skin, 1071 
Tapeworm, 1066 
Tapioca, 405, 505 
Tar-water, 718 

medical uses, 717 
Tartar, cream of, 704 
Taste in sickness, 625 
Tea as a beverage, 100 

in sickness, 482 

adulterations, 91 

iced, 103 

in neuralgia, 1010 
Teeth, care of, 128 

loss of, 293 
Temperance drinks, 102 
Temperature, of sick-room, 439, 390 

of drinks, 401 
Tetter, moist, 1077 

dry, 1082 

barber's, 1077 
Texas, its climate, 661 
Thermometer, uses of, 389 
Thieves' vinegar, 247 
Thirst, how to appease, 118 

a symptom, 633 
Thorn-apple, uses of, 744 
in asthma, 896 
as a poison, 1124 
Tic douloureux. (See Neuralgia.) 
Tight-lacing, 959 
Tinctures, 690 
Toast-water, 403, 512 
Tobacco, as a luxury, 112 

injures the eyes, 284 
the hearing, 303 
the heart, 937 

poisonous, 1124 

in asthma, 868, 897 
Toenails, in-growing, 1100 
Tongue in sick children, 374 

in disease, 623 
Tonic explained, 685 
Tonsils, position of, 630 
Toothpicks, 128 
Tooth-powder, 129 

wash, 130 

ache, remedies, 1108 

rash, in children, 1072 
Training, principles of, 179 



Travelling, precautions in, 175 
Trees prevent ague, 254 
Tripe, to cook, 495 
Tulip-tree, 726 
Tumors, 1104 
Turkish-baths, 463 
Turpentine, uses of, 718 
Typhoid fever, to avoid, 248 

description and treatment, 
1037 
Typhus fever, to avoid, 245 

to treat, 1041 



ULCERS, to cure, 696 
Undergarments, color of, 278 
Urine, to examine, 1088 
Uva ursi, 726 
Uvula, position of, 630 



VACCINATION, discovery of, 
V to perform, 243 
Yapor-bath, 466 
Varioloid, 849 
Veal, as food, 57 
Vegetables, as food, 74 

in sickness, 480 
Ventilation of dwellings, 149 

in children's diseases, 383 

of sick-room, 437 
Vermicelli, 503 
Vertigo, 267 
Vichy water, 650 
Vinegar as a condiment, 82 

medical uses, 719 
Vipers, bites of, 1123 
Virginia snakeroot, 746 
Viscera, the, 606 
Visitors to the sick, 392, 573 
Voice, loss of, 676 

in disease, 626 
Vomiting as a symptom, 632 

treatment of, 566 

in children, 377 

of blood, 698 



WAKEFULNESS, 186, 290 
in old age, 290 
Walking as an exercise, 172 
Wall-paper, poisonous, 157 
Walnut, white, 733 
Warming houses, 154 

a sick-room, 435 
Warmth of dead body, 323 

of aged, 595 
Warnings of apoplexy, 1026 
Warts, to cure, 1104 
Washing soda, 715 
Waste products, 141 
Wasting disease in children, 1063 



INDEX. 



1151 



Water, as a beverage, 95 

sometimes poisonous, 96 

excessive use of, 97 

to purify, 98 

dressing, 523 
Water-brash, 633, 650, 967 
Waters, iron, 645 

sulphur, 647 

alkaline, 649 

carbonated, 649 

salt, 651 
Weight of body, 614 
Weights, apothecaries', 553 
Wet sheet, packing in, 459 
Whispering in the sick-room, 585 
White walnut, uses of, 733 

lead paint, 1130 

snakeroot, 852 
Whooping-cough, description, 
1054 

remedies, 738, 750 



370, 



Wild cherry, 734 

Willow, medical uses, 735 

Wind in bowels. (See Flatulence. ) 

Words, last, 317 

Worms, prevention, 274 

described, 1066 

remedies for, 719, 738, 747, 1067 
Wormseed, 746 
Wounded, how to carry, 1133 
Wrist-drop, 221 
Wryneck, 819 



YEAST-POULTICE, 520 
1 Yellow fever, 1043 



ZEAL, mistaken, 584 
Zinc, as a poison, 1127 




/' 



